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January 19, 2012

The Healthy Librarian's Brand-New Weekly Facebook "Brain Backup" - My Favorite Health & Wellness News & Recipes for January 11-January 19, 2012

 

 

Facebook

 

 

If you received this via email, click here to get to the web version with all the links, and a video.

Missed it on Facebook?  Find it here.

A few readers told me they were disappointed that I started posting a lot of information only on Facebook--and not on HHLL.  Turns out, if you don't have a Facebook account, it's a pain to navigate a Facebook page.  Facebook keeps asking you to login.

The truth is--it's a lot easier for me to post "hot off the press" information on Facebook, without burdening you with multiple emails.

So...in an effort to not leave anyone out, I decided to see what you all think about a weekly collection of my Facebook posts.

Turns out--it's also a good way for me to refer back to the links, articles, & recipes I've posted--and it also makes them "sort of" searchable via the HHLL google search engine.  We'll see how well that works!

I left the comments off--in the interest of space.  Too bad--because the conversations are very interesting.

Let me know what you think!   Should I collect the posts in a weekly update?   Or not?

 

Happy Healthy Long Life - Healthy Librarian Facebook Posts - Jan. 13-19, 2012

 

 Note:  Sorry about the way the posts are sort of squished together!

 

January 19, 2012

 

Dr. Esselstyn on cholesterol

‎"Cholesterol is a white, waxy substance that is not found in plants --- only in animals. It is an essential component of the membrane that coats all our cells, and it is the basic ingredient of sex hormones. Our bodies need cholesterol, and they manufacture it on their own. We do not need to eat it. But we do, when we consume meat, poultry, fish, and other animal-based foods, such as dairy products and eggs. In doing so, we take on excess amounts of the substance. What's more, eating fat [even as added oil] causes the body itself to manufacture excessive amounts of cholesterol, which explains why vegetetarians who eat oil, butter, cheese, milk, ice cream, glazed doughnuts, and French pastry develop coronary disease despite their avoidance of meat." - Dr. Esselstyn

 

Dr. Esselstyn on oil

Oil was the LAST thing I removed from my cooking/diet. I couldn't imagine how I could cook without it. Trust me--you DO NOT NEED IT FOR COOKING. It's so easy to "saute" without it. Bonus: no greasy stove or pans! Everyone who learns how to cook without it is surprised how easy it is. Lots of easy substitutes for oil in dressings, too! You will not miss it!

Just to clear any questions up: NO OIL! Not even olive oil, which goes against a lot of other advice out there about so-called good fats. The reality is that oils are extremely low in terms of nutritive value. They contain no fiber, no minerals and are 100% fat calories. And above all they contain saturated fat which immediately injures the endothelial lining of the arteries when eaten. It doesn’t matter whether it’s olive oil, corn oil, or any other kind of oil. You should not consume any oil if you have heart disease. This is so important I have detailed oil in Chapter 10.- Dr. Esselstyn

 

January 18, 2012 

New York Times article discusses the latest New England Journal of Medicine article questioning the value of regular bone density tests.
Rethinking bone density tests--and prescribing bisphosphonates for osteopenia, in today's New England Journal of Medicine.

“Bone density testing has been oversold,” said Steven Cummings, the study’s principal investigator.

For years doctors were overly enthusiastic, prescribing it for women whose bone density was lower than normal but not in a danger zone, keeping women on the drug indefinitely.
www.nytimes.com
A new study is asking whether frequent bone density measurements make sense for the majority of older women whose bone density is not close to a danger zone on an initial test.
Study on Exercise Keeping Alzheimer's at bay, especially for those with the APOE-4 gene
Here's the New York Times write-up on the Exercise-Alzheimer's study recently published in the Archives of Neurology. If it sounds familiar, that's because I posted the press release five days ago. Gretchen Reynolds does a good job explaining the details. If any drug had as many benefits as does exercise-everyone would want to take it!
well.blogs.nytimes.com
A daily walk or jog could alter the risk of developing Alzheimer's or change the course of the disease if it begins in some people, a new study suggests.
NPR's Workout Song Mix
What's your favorite workout song? NPR has a mix for you to listen to--along with the song list to add to your own iPOD. I've got plenty of favorites--but Meat Loaf's full version of "Paradise" is fantastic in a spinning class! OMG! Tomorrow--4 new studies that will convince you to start exercising--if you aren't already.

www.npr.org

Hear an assortment of muscle-pumping, pain-annihilating anthems — as compiled by athletes, celebrities, NPR personalities and, of course, listeners.

 

 

January 17, 2012

New York Times - Reaction to Paula Deen's Type-2 Diabetes & her Novo Nordisk Drug Contract
Want to get angry? Read this. Yes, Paula has type-2 diabetes, and yes, she has a $$$ contract with Novo Nordisk to plug Victoza--a $500/month diabetes drug.

But, Paula says "she would not change her own lifestyle or cooking style drastically, other than to reduce portion sizes of unhealthful foods. "I’ve always preached moderation," she said. “I don’t blame myself.”

She feels like she cooks for ‘real people,’ and for better or worse, that is how many people in this country choose to eat. Her one concession is giving up sweet tea--made with 1 tablespoon of sugar.

www.nytimes.com

Paula Deen’s disclosure that she has Type 2 diabetes has added impetus to the debate on the national diet.
New England Journal of Medicine Study of Diet & Intestinal Immunity  (How Food Affects Gut Bacteria & Microflora & Can Strengthen Immunity)
Diet and Intestinal Immunity--Clinical Implications of Basic Research. New England Journal of Medicine. Herbert Tilg, M.D - 366:181-183, January 12, 2012

What we eat really matters to our immune system--and can change the "environment" of our guts--which strengthens our immune system.
Turns out--cruciferous vegetables, like broccoli, Brussels sprouts, cabbage, collards, cauliflower, kale, mustard greens, turnips, and rutabagas all have a unique "chemical" that is beneficial to the gut--Indole-3-carbinol.

This is BIG news! "“You are what you eat.” A couple of recent studies underscore the relevance of this adage to the immune system. New studies by Kiss et al [1] and Li et al [2] show how certain dietary components derived from vegetables (broccoli & Brussels sprouts) interact with intestinal immune receptors and thereby regulate the organogenesis of lymphoid follicles, intestinal immunity, and the microbiota." (yeah, I know, too much information)

Western diets are considered to be risk factors for certain diseases, particularly inflammatory bowel disease (IBD [3] High vegetable intake is thought to protect against ulcerative colitis, whereas a diet rich in certain fats, polyunsaturated fatty acids, and meat is considered to increase the risk of both Crohn's disease and ulcerative colitis. Accordingly, it is possible that dietary components prevent or induce inflammation in the gastrointestinal tract.

Kiss et al. and Li et al., by providing a compelling link between diet and protective immune functions, have opened up a new line of inquiry. The search for foods containing similar immunomodulatory compounds has begun.'

1. Kiss EA, Vonarbourg C, Kopfmann S, et al. Natural aryl hydrocarbon
receptor ligands control organogenesis of intestinal
lymphoid follicles. Science 2011 October 27 (Epub ahead of print).

2. Li Y, Innocentin S, Withers DR, et al. Exogenous stimuli
maintain intraepithelial lymphocytes via aryl hydrocarbon receptor
activation. Cell 2011;147:629-40.

3. Hou JK, Abraham B, El-Serag H. Dietary intake and risk of
developing inflammatory bowel disease: a systematic review of
the literature. Am J Gastroenterol 2011;106:563-73.

4. Monteleone I, Rizzo A, Sarra M, et al. Aryl hydrocarbon receptor-
induced signals up-regulate IL-22 production and inhibit
inflammation in the gastrointestinal tract. Gastroenterology
2011;141:237-48.

5. Opitz CA, Litzenburger UM, Sahm F, et al. An endogenous
tumour-promoting ligand of the human aryl hydrocarbon receptor.
Nature 2011;478:197-203.

Thanks to Dr. H for alerting me to this N Engl J Med article published last Thursday.

Jeff Novick's Easy Breezy Plant-Based No-Oil Recipes.  5 minutes - 5 or less ingredients - costing less than $5
My "Healthy Librarian" friend, Marlene's dream come true! 5 minute recipes, with 5 or less ingredients, that cost less than $5. Click on the photo & see the easy-peasy recipe. Not a new link--but still relevant & very useful! Probably not for the "foodies" among us. Sorry, Jeff.

Examples of some of my favorite simple recipes. Most all of them can be made in about 5 minutes, have less then 5 ingredients and cost much less than 5 dollars. These meals are very low in calorie density and very high in nutrient density so you can eat all you want till you are comfortably full without having to worry about portions size or going hungry. They are all based on my lecture, Calorie Density: How To Eat more, Weigh Less & Live Longer! Enjoy!

Photos: 29
Louisville Mike's All-Star Recipe Recommendation - Roasted Poblanos, Sweet Potato, & Black Bean Salad
I love roasted poblanos & HHLL reader Louisville Mike (a taste-conscious foodie) says this was a hit with his family. He skipped the olive oil when tossing the sweet potatoes, and used a little spray instead. His tip: definitely line the roasting pan with foil--my tip: use non-stick foil. This recipe has it all: Sweet potatoes, poblanos, black beans, corn, & spice. Can't wait to try it.

budgetbytes.blogspot.com

I've made this dish several times now and love it.Thanks for posting it (found you through tastespotting)the only thing i change is that i put the onions and corn (plus some garlic) in with the potatoes and roast them all together. less of a sharp onion flavor then. and i add all the cilantro in a...
Janice Stanger Interviews a Plant-Based Health Super Star--Don't Miss This One

You cannot read a more inspiring story of a health-turnaround from a high cholesterol, obesity, & back pain. Lynne Morrissey is a plant-based & exercise rock star. Thanks to Janice Stanger for posting this! Don't miss it!

perfectformuladiet.com

Lynne Morrissey is a Facebook friend with an inspiring story of survival against heavy genetic odds. Lynne, who lives near St. Louis, Missouri, just turned 50 and has four adult children. She is sharing her achievements so she can show others to never give up. Health is just a forkful away.
Healthy Girl's Kitchen Farmer's Pie Recipe

I loved this recipe--as did others readers who tried it.  It could use more seasoning, though, and Penzey's Salt-Free Forward sprinkled on my individual serving kicked it up a notch!
I'm making Wendy's Farmer's Pie tonight! Quick & nutrient-dense with sweet potatoes, lentils (TJ's), mushrooms, spinach, onions, peas & garlic. Left-overs for lunch & dinner tomorrow with a 9 x 13 "pie"! Thanks Wendy & Jill!

healthygirlskitchen.blogspot.com

Healthy weight loss recipe blog inspired by Eat to Live, The Engine 2 Diet, Nutritarian eating, Fat Free Vegan and Volumetrics.

 

 

January 16, 2012

 

The New York Times.  The Connection of Hearing Loss to Dementia.  How Hearing Aids Help!

This is an astonishing finding! Here's how hearing loss can contribute to dementia, rather than the other way around. A good reason to get your hearing checked.

“The brain dedicates a lot of resources to hearing. When the clarity of words is garbled, the brain gets a garbled message. It has to reallocate resources to hear at the expense of other brain functions,” according to Dr. Frank R. Lin of Johns Hopkins.

Thus, the overworked brain may lose “cognitive reserve,” the ability of healthy parts of the brain to take over functions lost by other parts.

well.blogs.nytimes.com

This "hidden" disability, currently untreated in about 85 percent of those affected, may be the nation's most damaging sensory handicap.
The Vitamin D & Ulcerative Colitis Connection
Study appearing in Gut. "A leading explanation for this north-south gradient in the risk of ulcerative colitis and Crohn's disease may be differences in exposure to sunlight, or UVB radiation, which is generally greater in southern latitudes," wrote Dr. Hamed Khalili, of Massachusetts General Hospital in Boston, and colleagues.

"UV radiation is the greatest environmental determinant of plasma vitamin D, and there is substantial experimental data supporting a role for vitamin D in the innate immunity and regulation of inflammatory response," they noted.

www.nlm.nih.gov

Inflammatory Bowel Disease Less Common in Sunny States
Vegans Have the Lowest Risk for Hypertension - The Latest Adventist Health Study
Adventist Health Study 2--just out. Vegans had a 63% reduced risk of having high blood pressure, as compared to regular meat-eaters. Lacto-ovo vegetarians had a 43% reduced rate. The reason for the lower blood pressure? Lower body weight, higher potassium intake, lower sodium intake, & lower insulin levels, for starters.
jacknorrisrd.com
New York Times - The Downside of Cubicle Offices & Group Decision-Making.  Why Quiet & Solitude Promotes Creativity & Our Best Work
If you crave silence & alone time when you work, think, write, or read--you are going to LOVE this essay. I work in a noisy cubicle office--so you can just imagine... Learn why solitude is important to creativity--and why "work by committee" falls flat.

www.nytimes.com

Collaboration is in. But it may not be conducive to creativity.

 

 

January 15, 2012

 

Seitan Gyros with Tzatiziki Sauce for Sunday Night Dinner

We had Seitan Gyros withTzatziki Sauce for dinner tonight! Amazing. If you haven't tried these yet--you don't know what you're missing! Double the Gyro part of recipe so you'll have some for lunch--sauce doesn't have to be doubled. Leave out the onion!! My BIL didn't & he wished he had.

I LOVE this recipe!!  The Tzatziki Sauce makes a great salad dressing, too!

www.happyhealthylonglife.com

My New Go-To Fave Cookbook--Quick-Fix Vegan, by Robin Robertson "You don't have to be a full-time vegan to love this book. Quick-Fix Vegan is packed with 150 fast and easy recipes for putting delcious, healthy food on the table in...
Do Anti-Perspirants Really Have a Connection to Breast Cancer????  Or Is It Just an Urban Legend?
The association between anti-perspirants & breast cancer always seemed the stuff of urban legend--now a new study in the Journal of Applied Toxicology might be changing that. The possible culprit? Parabens--and maybe aluminum. An easy fix. Check the content of your anti-perspirants, cosmetics, & lotions in the EWG's site: http://www.ewg.org/skindeep/
myemail.constantcontact.com

 

New Study -  Increased Consumption of Magnesium-Rich Foods Lowers Stroke Risk

For every extra 100 milligrams of magnesium a person ate per day, their risk of an ischemic stroke -- the most common kind, typically caused by a blood clot -- fell by nine percent. The median magnesium intake for U.S. men and women included in the analysis was 242 milligrams a day (mg/d). The U.S. recommends men and women over age 31 eat 420 and 320 mg/d of magnesium, respectively.

www.reuters.com

NEW YORK (Reuters Health) - A fresh look at past research concludes that people who eat lots of greens and other foods rich in magnesium have fewer strokes -- a finding that supports current diet guidelines. But...
New Study in the Physician & Sportsmedicine - Lifelong Exerciser Preserve Their Muscles - Muscle Atrophy as We Age is Not Inevitable.
Exercise, baby! Don't stop--and start if you don't! From a study in The Physician and Sportsmedicine that took detailed measurements of 40 masters athletes between the ages of 40 and 81, and found a surprising lack of age-related muscle loss: This study contradicts the common observation that muscle mass and strength decline as a function of aging alone. Instead, these declines may signal the effect of chronic disuse rather than muscle aging. Thanks Janet for the link! I was actually planning to write about this one & 2 other pro-exercise articles, today. But, I was spinning & yoga--ing.
sweatscience.com
The incredible unaging triathlete

 

 

January 14, 2012 

How to Find Real Food at the Supermarket
Another gem from my Healthy Librarian colleague, Marlene! Hilarious!

 

Findfood

Robin Robertson's Fantastic  Roasted Vegetables with Lemon-Cannelini Sauce
I'm going to try this one tomorrow--minus the oil. This is one of Robin Robertson's recipes--One of my faves--author of "Quick-Fix Vegan"--so it's got to be good. Thanks to Lani for forwarding this to me.

I highly recommend this dish.  It's so easy, so tasty, so pretty to look at, and so nutritious.  Just vegetables & beans--that taste like restaurant fare.

www.onegreenplanet.org
If adding more vegetables to your diet is one of your resolutions for a new year, here’s a delicious way to do it. Cut up a few different vegetables (the more the merrier) and roast them until tender, then top with a luscious and protein-rich cannellini bean sauce.
 

Happy Healthy Long Life - Cholesterol: Fact of Fiction?

 
www.happyhealthylonglife.com
About a week ago I received an email from a reader in New York. She asked a really good question. But, I wanted an expert to answer it. The Back Story She had just received a copy of the January...
 

New Study from Fred Hutchinson Cancer Center.  C-Reactive Protein Decreases with a Low-Glycemic Carbohydrate Diet

Big news from the esteemed Fred Hutchinson Cancer Center: "This finding is important and clinically useful since C-reactive protein is associated with an increased risk for many cancers as well as cardiovascular disease," said lead author Marian Neuhouser, Ph.D., R.D., a member of the Cancer Prevention Program in the Public Health Sciences Division at the Hutchinson Center. "Lowering inflammatory factors is important for reducing a broad range of health risks. Showing that a low-glycemic-load diet can improve health is important for the millions of Americans who are overweight or obese."
www.sciencedaily.com
Among overweight and obese adults, a diet rich in slowly digested carbohydrates, such as whole grains, legumes and other high-fiber foods, significantly reduces markers of inflammation associated with chronic disease, according to a new study. Such a "low-glycemic-load" diet, which does not cause bl...

 

 

January 13, 2012

Just Heard.  Paula Deen Has Type-2 Diabetes.  It's rumored she also has a hefty drug company contract.  True or False?
The diabetes diagnosis part is true. The Novartis spokesperson part probably isn't. Deen was rumored to be a new spokesperson for the Novartis diabetes drug, but now the Atlantic wire is nixing the rumor. We'll have to wait & see. Here's New York Grub Street's story: "Deen made a mountain of money peddling her butter-soaked food, and now she's poised to make millions more with a "rumored" deal with Novartis as a spokesperson." Thanks Babs for sharing the story.
newyork.grubstreet.com
And the Daily says she's poised to make millions off of it.
Exercise Can Fight the Genetic Risk of Alzheimer's
Off to the gym!!! Dr. Robert Green's (study author) BOTTOM LINE:

“As we get older, there are an awful lot of things that influence brain health. The way I think of it is that if you’ve got a disease that’s slowly brewing in your brain and you keep yourself as healthy as possible, and you keep the vascular load on top of that disease — the stuff gumming up the arteries in your brain — if you can keep that to a minimum, then with whatever genetic load you have, and whatever underlying developing disease you have, you do better.” This research confirms many others over the past few years! Eat plant-based heart & brain healthy & exercise. They both boost nitric oxide.
commonhealth.wbur.org
I know, we’ve already linked to this study on exercise and Alzheimer’s, but I just wanted to come back to it because the findings struck me as so dramatic. As Bloomberg reports...
 

Vitamin D Expert, Bruce W. Hollis, PhD Doesn't Put Much Stock in Latest Study That Links an Increase in Inflammation to Increases in Vitamin D

Just received an email from one of my favorite Vitamin D researchers Bruce W. Hollis, PhD.--about that NYT & Am J Cardiol Vitamin D article:

I had seen it and like you I yawned. Another association study that may be negative. I weigh it against all the positive associated studies and so to me it does not mean much.

Who's Hollis? Read this. http://www.happyhealthylonglife.com/happy_healthy_long_life/2010/02/vitamin-d.html

 

New York Times on a New Vitamin D Study That Links an Increase in Inflammation to Increased Vitamin D Intake.  A National Vitamin D Expert Responds
Read the response from the knowledgeable Vitamin D researchers! I read the American Journal of Cardiology article. The results were unremarkable and I'm not stopping my Vitamin D! http://blog.vitamindcouncil.org/2012/01/11/response-to-crp-and-vitamin-d-association-finding/
www.nytimes.com
Vitamin D supplements reduce blood levels of an indicator of inflammation that is linked to cardiovascular disease. But too much can raise those levels.
 

Dr. Esselstyn's November 2011 Cambridge TED Talk.  Fourteen Minutes You Don't Want to Miss

Just 14 minutes long. Dr. Esselstyn's November 2011 TED Talk. Change your nutrition to change your internal biochemistry--and in essence treat the causation of heart disease. Avoid the foods that injure your endothelium and eat the foods that will heal it.
www.youtube.com
Dr. Caldwell Esselstyn argues that heart attacks, the leading cause of death for men and women worldwide, are a "foodborne illness" and explains why diet is ...

 

Daily Garnish's Delicious Nutrient-Paced Triple Bean Indian Spiced Chili

We loved this so much I decided to post my variation. Make it this weekend!
www.happyhealthylonglife.com
Indian Chili - Daily Garnish's Recipe, Tweaked by the Healthy Librarian I have no business posting a recipe before I head out of the house this morning--then on to the gym, then on to work, & then on to a...

 

 

January 11, 2012 

The New York Times.  What's a Vegetarian Living in Midwest Meat Country to Do?
Great read! There are zero full veg restaurants in my hometown. The upside? You don't often eat in restaurants & you get real good at trying out amazng new recipes. But I do envy New Yorkers, big time!! What's it like where you live?


www.nytimes.com
For vegetarians in the meat-loving heartland, eating can be a constant struggle.

Posted on January 19, 2012 at 02:52 PM | | Comments (29)

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January 10, 2012

A Balanced Look at the New York Times' "How Yoga Can Wreck Your Body" - What We Can Learn From William J. Broad's Research and a Response from a Long-Time Yoga Teacher

 

HowYogaCanWrieckYourBody

Photo: Danielle Levin, NYT

 

"How Yoga Can Wreck Your Body,"  by William J. Broad, New York Times, January 5, 2012

 

 

"Among devotees, from gurus to acolytes forever carrying their rolled-up mats, yoga is described as a nearly miraculous agent of renewal and healing.

They celebrate its abilities to calm, cure, energize and strengthen. And much of this appears to be true: yoga can lower your blood pressure, make chemicals that act as antidepressants, even improve your sex life.

But the yoga community long remained silent about its potential to inflict blinding pain."

“[Long-time yoga instructor, Glenn Black's] message was that 'Asana is not a panacea or a cure-all. In fact, if you do it with ego or obsession, you’ll end up causing problems.’ A lot of people don’t like to hear that.”

-William J. Broad, "How Yoga Can Wreck Your Body,"  New York Times Sunday Magazine 1/8/2012

 

 

If you received this post via email, click here to get to the web post, with all the links, and to leave me a comment.

If you haven't yet visited my "brand new" Facebook page Happy Healthy Long Life - The Healthy Librarian, please do.  Lots of new stuff, every day.

 

 

Last Sunday the New York Times trashed diets, when Tara Parker Pope told us, "Forget about losing weight.  It's not going to happen."

This Sunday, they are telling us to watch out for yoga!  The one physical activity we all thought was "safe" for bodies of all ages.  Not!

But, not so fast!   Believe it or not, the article is worth reading.  If you've attended a yoga class since the article hit the net--I'm sure you've heard the buzz--and your teachers all had something to say about it. 

Mostly, though, it's pretty much common sense.  I'm appreciative of Broad's research.  It confirms what I've thought all along.  Give me safe, slow, and restorative!

But, before I get into what the article says about the risks of yoga--plus a thoughtful, balanced, & knowledgeable response, written by a long-time Iyengar yoga teacher in Massachusetts (who reads HHLL), here's the inside scoop about the author, William J. Broad--the part that the New York Times neglected to tell its readers:

 It puts things into perspective.

 

Scienceofyoga



William J. Broad, didn't only write the "watch-out for yoga" expose we all read in the Sunday Times. 

Here's what the NYT neglected to tell us:

That article was only an excerpt from one chapter of his new book--The Science of Yoga: The Risks and the Rewards.  Yes, you heard that right!  Rewards.

Broad is a Pulitizer Prize winning science journalist for the New York Times, who has practiced yoga since 1970--and he's spent the last five years investigating all the health claims & safety risks made in the name of yoga.

His research confirms that yoga improves stress, health, mood, creatvity--and lowers blood pressure & improves cardiac health.  It won't, however, help you to lose weight or oxygenate your blood with yogic breathing.  Good to know.

Robert Love, who recently reviewed the book in the February 2012 issue of the Yoga Journal, says the book is balanced, with Broad presenting research on yoga's darker side.  It's not without its risks--just like any other sport or physical practice. (Thank you Iyengar teacher from Massachusetts for sharing this review with me.)

 

"Broad's book will no doubt get attention for the 34-page chapter devoted to yoga's dark side--which he defines as the risk of injury, illness, and death.  He writes about the danger of stroke and vertebrae damage in the longtime practice of inversions such as Plow, Headstand, and Shoulder Stand--correctly labeling medically documented tragedies as rare but significant events.

Broad sees his work as a kind of "informed consent" for yogis.  He reveals the dangers, and he leaves it up to the individual to find an intelligent, healthy practice."  (Amen, I say! H.L.)

 

 

The Darker Side of Yoga

 

OK, a little back story.

I took my first yoga class in 1972--and back then, it was the slower, gentler variety.  I've practiced on and off over the years, but I've been a regular for the past 10 years or so.

I've been to every possible kind of class. 

  • The Power Yoga classes taught by former-aerobic instructors and dancers.  I'm not a fan.
  • The Restorative Yoga classes with props--and careful moves.  I'm a fan--but I don't attend these often enough, because I still like to be challenged. 
  • The generic yoga classes taught by teachers who have studied for years, and the newbie teachers who know less than I do--and were "certified" with a 30 hour course.
  • Iyengar, Ashtanga, Hatha, Anusara, Jivamukti, Kripalu, Integrative, & Vinyasa Yoga.  I've attended classes with teachers trained in all these disciplines.  Dr. Loren Fishman, the physical medicine specialist who uses yoga in his own practice, recommends Iyengar & Anusara, because of the training required, and their more gentle, safe, and careful yogic approach.  And going to a teacher with at least 5 years of training.
  • Since reading Broad's article, I've attended two classes that prove his point.  There were older seriously out-of-shape beginners who were doing moves that could hurt them--and the class was too big for the teacher to either notice, or be able to properly correct them.  Students can easily get caught up in trying to "do everything" and not listen to their own bodies.

Bottom line for me.

  • It's all about who is teaching the class.  I want a teacher who is experienced, careful, and can describe in minute detail how I can self-adjust my body to get into the proper position.
  • I want a class that restores my body, doesn't punish it.  I do yoga to gain flexibility, balance, strength, calm me, and change my outlook.
  • I'm not looking for a cardio work-out, or to get into crazy scary poses.  I've never done the crow pose, let alone side crow.  I no longer do shoulder stands, or the Plow.  I've only done a very carefully executed headstand, without any pressure on my head--assisted by a teacher I trust--and supported by a wall.
  • Yoga postures balance out my tight spinning-class muscles.  I absolutely have experienced the benefits of yoga postures that relieved the discomfort I sometimes get from piriformis muscle strain (aka sciatica) caused by sitting & crouching-over on a bike.  Dr. Loren Fishman does a good job of explaining just how yoga helps sciatica.  But, that's for another post.  Promise!

 

 

Yoga's Risks - William J. Broad's Warnings

 

Broad's a long-time yoga student, who began practicng in his 30's, after he ruptured a disk in his lower back, and found that he "could prevent bouts of pain with a selection of yoga postures and abdominal exercises."

But, then....while in an extended side-angle pose in 2007--"hailed as a cure for many diseases"--his back gave way.  That's when he had his epiphany--that yoga can work both ways.  As a source of healing, and of harm.  

Side Note:  The side-angle pose gave me some instant back problems, too, a year ago--but, in my case--it was the "straw that broke this camel's back".   It was really started by a combo of bike riding in that awkward crouched position, coupled with inadequate stretching afterwards, a couple days of too much sitting, and twisting my torso to work on my computer.  Yeah--too much info. 

Just saying...Broad's back problems might have had a non-yogic origin.

 

Problems in the Yoga World

  • Some teachers who try to make it "as hard as possible"  & leave it up to the student to make it easier on themselves.
  • Many celebrated teachers sustain their own injuries, because of underlying physical weaknesses, that make injury inevitable.  There are teachers with bad backs & degenerated hip sockets--but their egos prevent them from realizing that yoga has caused the damage.  They would be wiser to work on strengthening the weak parts of their bodies and improve the range of motion, instead of doing a set series of poses.   (H.L.  In my favorite class, that's exactly what we do--work on strengthening weak muscles, and improving range of motion)
  • Well-known yoga teacher, Glenn Black believes he developed painful spinal stenosis from over 20 years of extreme back bends & twists.  Black has now recovered from the spinal fusion surgery that relieved his pain--but his range of motion will never be the same. Without surgery, his surgeon said he eventually would have been unable to walk.

The  Downside of Yoga's Increase in Popularity

  • Popularity has soared.  More people--more injuries.  Yoga's exploded from 4 million students in 2001 to 20 million students in 2011
  • Older & less flexible students.  Many student's are older--and most of us sit in chairs all day long and we're inflexible.  Going to a studio 1 or 2 times a week & then twisting into "ever-more-difficult" poses is bound to cause strain.
  • The Gentler Alternative Isn't Always Gentle.  Many student's come to yoga as a "gentle alternative to vigorous sports or rehabilitation for injuries"--but, too many studios have teachers who "lack the deeper training necessary to recognize when students are headed toward injury".  Some teachers unwisely, push students beyond their abilities.

Poses to Watch Out For

Broad goes on to list a number of serious injuries that are blamed on specific yoga poses--and he's interviewed some of the physicians who have written articles on yogic injuries.

Here's what I want to stress.  Much of what Broad puts forth as evidence of risk is coming from "case reports"--which is a medical article written about an unusual, previously unreported case.   Get that?  Unusual.  Previously, unreported.

 

"A Growing Body of Evidence?"    When I did a literature search of the PubMed database of medical articles back to 1946, I came up with only 17 articles on injuries reported from yoga.  Most of these were case reports--which most physicians wouldn't get too excited about.  Granted, I didn't spend a long time coming up with the most detailed of search strategies--but, far & away, most of the articles written about yoga were on its benefits--not its risks.

I've created at page with the medical journal citations I found on Medline/PubMed.   Click here to see them, if you're interested.  If time permits--I'll search further.

 

Now back to Broad's list of yogic injuries & risky moves


  • Yoga foot drop.  This will surely scare you.  A male college student sat upright on his heels in a kneeling position (vajrasana) for hours a day.  He experienced difficulty walking, running, and climbing stairs because of nerve damage to a peripheral branch of the sciatic nerve.  He improved rapidly when he gave up the pose.  There are about 5 reports of yoga foot drop.  (Watch out for this one, dear readers!)
  • Excessive neck flexion & head trauma.  Vertebral artery injuries.  Nerve compression. The serious stuff.  "While rare, some yoga postures threaten to cause strokes, even in relatively young, healthy people," according to Oxford neurophysiologist, Dr. W. Ritchie Russell (see: British Medical Journal, 1972)  

Watch out for direct trauma to the head in head stands, quick movements or excessive extensions or hyperflexion of the neck, as in cobra pose, the wheel, or incorrectly executed shoulder stands "with the neck maximally flexed to the floor" (click here for that report)--which Russell warns can injure vertebral arteries, producing clots, swelling and constriction, and eventually wreak havoc in the brain.  These poses can also cause nerve compression.

The basilar artery is of particular concern, according to Russell--because reduction of blood flow can produce strokes.  The majority of patients suffering such a stroke do recover most functions.

"Normally, the neck can stretch backward 75 degrees, forward 40 degrees and sideways 45 degrees (good to know), and it can rotate on its axis about 50 degrees.  Yoga practioners typically move the vertebrae much farther--like 90 degrees."  I'll be watching for that one.

  • Emergency room visits have increased with 13 in 2000, to 20 in 2001, and to 46 in 2002.  Broad seems to forget that he already told us that the number of students is increasing rapidly.  Of course we'd expect to see more injuries.  That said--remember that only a fraction of those injured ever visit an emergency room.  Most people just see their family doctor or a chiropractor. 
  • Hot yoga.  "[H]ealth professionals [have] found that the penetrating heat of Bikram Yoga could raise the risk of overstretcing, muscle damage and torn cartilage. One specialist noted that ligaments--the tough bands of fiber that connect bones or cartilage at a joint--failed to regain their shape once stretched out, raising the risk of strains, sprains, and dislocations."
  • Lower back injuries are the most common yogic injuries, followed by shoulder injuries, knee & neck injuries--as reported in a 2009 Columbia University College of Physicians & Surgeon's worldwide survey of yoga injuries.  There were 4 cases of some degree of brain damage caused by extreme bending & contortions also reported in this survey.  Sorry, I was unable to find a citation to the survey results.  

 

The Flip Side--Yoga Can Relieve Lower Back Pain

 

Yoga trumps traditional medical care for chronic & recurring lower back pain.  This article appeared in the Nov 1, 2011 issue Annals of Internal Medicine 2011;155:569-578 and I definitely took notice. 

But this wasn't just any yoga.  This large, well-designed 12 month British study employed an Iyengar-style yoga that was practiced at multiple study sites, where students attended 12 weeks of yoga classes. 

The movements are careful and slow.   Instructor's make sure that the students' positions are correct, and they teach safe postures & body alignment, along with relaxation.  But, gee whiz!  Why were the researchers surprised to find out that in order to keep back pain at bay--the students had to keep attending classes & practicing? 

All the students received a book of detailed postures & routines for home study, as well as a relaxation CD.  Interested?  Here's the good news:   the book & the CD used in this study will be available for purchase around December, 2011.   Go to this website for all the details.   Go to this link for 2 short videos that explain the results of the study, and the specific yoga techniques that were used.

 

The Other Side of the Yoga Story - A Teacher's Response to "How Yoga Can Wreck Your Body"

 

Last Friday night I emailed a regular blog reader, who I know is the kind of yoga teacher we all want to have.  She's dedicated, well-trained, and brings a quality to her classes that not only improves her students bodies, but nourishes their souls.

I asked her if she would write a response to Broad's New York Times article--and she generously accepted.

Here it is.   Thank you so much, my favorite Iyengar yoga teacher from Massachusetts!

IMHO--She does a much better job than William Broad, in explaining how to safely navigate the yoga world--and find a class that will work for you!

 

 

What a Yoga Teacher Wants You to Know

 

Her Back Story

"I have been studying yoga since 1993 and teaching  since 1999 after graduating from a intensive teacher training program. I have been fortunate to study and teach in the Iyengar style for all of that time. I see about 80 students a week and many have been with me since I began teaching.

I love what I do and I have witnessed the deep and profound benefits of yoga for myself and my students.

I consider yoga a kind of extreme mindfulness training that begins with the physicality of asana practice and eventually, hopefully, spreads into all aspects of one's life.

 

The Yoga Disconnect - Unrealistic Expectations


 In response to the William Broad article, I believe yoga suffers from two popular disconnects: a very high expectation level (I can look like the models in Yoga Journal and attain a high level of strength and flexibility if I attend class on a weekly basis) and a very low threshold of admittance (yoga is for everyone no matter what one' s physical condition).
 

These two beliefs create a pool of students with enormously unrealistic expectations who are the majority of students seen by yoga teachers.

Over time both of these expectations generally even out through experience and sadly enough sometimes through injury. One can imagine the result if these two kinds of thinking were applied to attaining minimal proficiency in almost any other physical discipline, e.g ballet, martial arts, archery, swimming.
 

Students are not the only ones with unrealistic expectations.

Yoga teachers with backgrounds in dance and gymnastics may also meet their students with unrealistic expectations.

It's like having a math teacher who finds the currency of numbers an easy universe in which to move. One really wants the math teacher who knows and understands the struggle of making that universe feel like home. In addition, what teachers expect and in some cases demand of themselves can also be unrealistic and ultimately injury producing.

 

In the early days, yoga was transmitted individually from teacher to student.

Only later when yoga became popular were large classes considered acceptable. This has enabled many people to enjoy yoga who would not have in the previous arrangement, but presents serious issues for students as well as teachers.
 

The Iyengar method in contrast to some other yoga schools has a very solid pedagogy.

There is a syllabus of poses in ascending difficulty and technically one does not progress to the next level unless proficiency is demonstrated in the lower levels. In a general class that is not always possible.

The Iyengars have changed the way shoulderstand is done since the early unsupported method and now it would be very unusual to find an Iyengar teacher who did not required the use of stacked blankets under the shoulders to prevent the flattening of the cervical curve.

However, one problem is that teachers tend to expect students to self-eliminate themselves from poses that concern them. That is very tough for students to do who driven by the desire to please the teacher and do what they sense is expected. 

My teacher used to say to some very driven students in class, "Work with 20% less effort." Perhaps that percentage is too low now and should be revised upward.

 

Some basic bottom-line suggestions



1.   Insist on an a certified teacher. Check with Yoga Alliance: www.yogaalliance.org for a certified teacher.

2.  Hunt out a small class. Ten is ideal. Over 20 is getting too big.

3.  Attend class regularly.

4.  Avoid classes in gyms. Sorry, but I've taught them. They are too general. Too many newbies and not enough consistency. Once in awhile, you'll get an exceptional teacher but it is an exception.

5.  Graciously decline doing poses that worry you or make you tense. Ask for  similar but not so difficult poses.

6.  Accept that you will need to practice at home to enrich your class experience and commit to it. 

7.  Be kind to your yourself and savor what should be an absorbing and interesting time on the mat.
Namaste!

 

 I cannot thank our "anonymous" yoga teacher from Massachusetts, enough.  Her response to the article, and her suggestions are helpful, balanced, & honest.

I know one thing--I'm going to start looking for a smaller class.  She's absolutely right.

 

OK, all you yogis & yoginis out there.  What did you think of the New York Times article?

What kind of yoga class is your favorite?

 

Coming up:  What's good about yoga?  What does Dr. Loren Fishman say about how yoga can benefit our bones & joints?

 

 

 

 

 

Posted on January 10, 2012 at 12:53 PM | | Comments (7)

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September 27, 2011

The Healthy Librarian's Brain-Backup for This Week's Health News: Estrogen, Erectile Dysfunction, Diabetes, Dementia, Deli Meats, High-Protein Diets, Vitamin D, Bisphosphonates, Hot Flashes, and High Fiber Carbs

 

 

  BrainBackup

"Once You're Through Learning, You're Through"

 -John Wooden, the well-known UCLA basketball coach, who passed away at age 99-


If you you received this post via email, click here to get to the web version with all the links.

 

The research on the benefits of diet and exercise just continues to pile up on my desk! 

There's no way to keep up with it all--so today I'm "downloading" just a few of the papers that caught my attention this week. 

Nothing "earth shattering".   Much of what you'll see here is just further confirmation of prior research.


Thumbs Up: 

  • A diet high in fiber-rich carbohydrates helps prevent type-2 diabetes & metabolic syndrome.
  • Get your vitamin D level up to 33 or more, if you want your bisphosphonates to work.
  • Bio-identical estradiol significantly improves the verbal memory of postmenopausal women
  • Help to prevent dementia by avoiding diabetes & lowering your cholesterol.
  • Avoid erectile dysfunction by making the necessary diet & lifestyle changes that improve cardiovascular health.
  • Help to prevent stroke by steering clear of deli meats.

Thumbs Down:

  • Deli-counter meats--yes, even low-fat turkey--contribute to an increased risk of stroke.  Looks like salt & nitrites are to blame.
  • High-cholesterol is bad news for the brain--contributing directly & indirectly to amyloid plaque formation in the brain.
  • A diet high in animal protein can promote type-2 diabetes by increasing low-grade inflammation.
  • Conjugated Equine Estrogen may not be good for the brains of women at risk for dementia
  • There's a link between hot flashes and high cholesterol.
  • Diabetes is a major risk factor for dementia because it increases vascular disease.
  • Erectile dysfunction needs a diet & lifestyle makeover--not Viagra & Cialis.

 

 

1.  Diet high in protein, processed meat raises risk of diabetes

 

High protein intake may facilitate type 2 diabetes and metabolic disturbances, mostly through the elevation of low-grade inflammation.

 

September 16, 2011.  Presented in Lisbon, Portugal at the European Association for the Study of Diabetes (EASD) 2011 Meeting.

 

Excerpt from Medscape (to view you must register, but it's free):  Results of a large population-based study (27,140 individuals) show that a high protein intake is associated with an increased incidence of type 2 diabetes.

In presenting their results at the recent European Association for the Study of Diabetes (EASD) 2011 Meeting, Swedish researchers suggest that replacing protein with carbohydrates, especially breads and cereals rich in fiber, may be preferable for avoiding incident diabetes. 

The study participants with the highest intakes of protein were at a 37% increased risk of developing type 2 diabetes, compared to those with the lowest intake.

High intake of processed meat was also associated with an elevated risk of diabetes, as was intake of poultry and eggs.  There was no association of diabetes risk with intake of fish or red meat, but when all animal sources of dietary protein were considered together, an increased risk was seen.  "So this indicates that protein per se may be of importance," according to lead author Ulrika Ericson.

High protein intake may facilitate type 2 diabetes and metabolic disturbances, mostly through the elevation of low-grade inflammation.

In summary, Ericson said a protective association exists with a high intake of fiber-rich breads and cereals.  And although high protein intake has been shown to be effective for short-term weight loss and glycemic control, it is associated with an increased risk of type 2 diabetes. 

So, the results of this trial suggest caution when considering high-protein diets--although Ericson says it's too early to make dietary recommendations based on merely on the observed associations.

 

For a better understanding of how high-fiber low-glycemic carbohydrates help to prevent type 2 diabetes & metabolic syndrome, take a look at:  

There's More to the Whole-Grain Story.  A Calorie is Not Just a Calorie.  Carbs Affect Our Genes.  What? (then scroll down halfway to find this gem!)

Tip: whole wheat bread may be high fiber, but it's also high glycemic.  Find a better choice!

Bottom line: you want very grainy "kibbled" least-processed breads & carbs that move slowly through your digestive system. How do I find out which foods are low-glycemic?  The University of Sydney maintains the most reliable database.  Look for foods that have a glycemic index of 55 or under.  Click Here for the database.  Click Here for their excellent newsletter.

 

Also take a look at:  Larrson, SC, Virtamo, J., Wolk, A. "Red Meat Consumption and Risk of Stroke in Swedish Men,"  Am J Clin Nutr 2011 Aug;94(2):417-21.

 

"The largest study to date on the relationship of stroke to red meat consumption suggests higher intake of processed meat, but not fresh red meat, is associated with an increased risk for stroke, including cerebral infarction.

The findings suggest meats that consumers often think are healthier, such as low-fat deli turkey, ham, and bologna, may actually increase the risk for stroke if intake is high enough, the study authors note. 

The investigators speculate that sodium in processed meats, which can contribute to the development of hypertension if intake is high enough, might contribute to a higher risk for stroke by promoting vascular stiffness or oxidative stress.

Nitrites used as preservatives may also contribute to increased stroke risk."  Read more in Medscape (must register first--but it's free)

 


 

2.  HIgh Cholesterol tied to Alzheimer's disease lesions

 

"Our study clearly makes the point that high cholesterol may contribute directly or indirectly to plaques in the brain," corresponding author Dr Kensuke Sasaki.  


September 13, 2011.  Matsuzaki T, Sasaki K, Hata J, et al. Association of Alzheimer disease pathology with abnormal lipid metabolism: The Hisayama study. Neurology 2011; 77:1068-1075. 

 

Excerpt from Heartwire.  Kyushu, Japan - A new study has found a correlation between dyslipidemia and the presence of amyloid plaques in the brain at autopsy, one of the key signs of Alzheimer's disease.

According to the analysis, levels of total and LDL cholesterol, as well as ratios of LDL to total cholesterol and LDL to HDL cholesterol, were significantly higher among subjects with increased numbers of neuritic plaques vs those with fewer plaques. No such relationship was seen with numbers of neurofibrillary tangles, the other cardinal pathological sign of Alzheimer's disease.

"Our study clearly makes the point that high cholesterol may contribute directly or indirectly to plaques in the brain," corresponding author Dr Kensuke Sasaki (Neurological Institute, Kyushu University, Japan) said in a statement by the American Academy of Neurology.

However, he added, "Failed treatment trials of cholesterol-lowering drugs in Alzheimer's disease mean there is no simple link between lowering cholesterol and preventing Alzheimer's."  (My comment:  Could changes in one's cholesterol that come from diet & lifestyle have more of a protective impact than those from statins?  And don't forget that Alzheimer's & vascular dementia are years in the making!)

The study, published in the September 13, 2011 issue of Neurology, looked at autopsy brain specimens from 76 men and 71 women who had undergone clinical examination in 1988 and had total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides measured at that time. Of the 147 subjects, 34% had been diagnosed with dementia when alive.

 

For additional perspective read,  Mayo Clinic Researchers Discover the Nitric Oxide Connection to Brain Health, Alzheimer's, and Cognitive Impairment. Better Keep Your Endothelial Cells Healthy with Diet & Exercise

 

3.    Bisphosphonates Most Effective With Higher Vitamin D Levels  

 

Women whose mean level of serum 25 hydroxy vitamin D (25[OH]D) was at least 33 ng/mL were almost five times more likely to benefit from bisphosphonates than those whose levels fell below that cutoff.

 

September 21, 2011.  American Society for Bone and Mineral Research (ASBMR) 2011 Annual Meeting; Abstract #1137. Presented September 18, 2011

 

Excerpt from Medpage Today & Medscape: Bisphosphonate therapy for osteoporosis is much more likely to be effective among patients whose blood serum levels of vitamin D are elevated, according to research presented here at the American Society for Bone and Mineral Research (ASBMR) 2011 Annual Meeting.

Postmenopausal women with low levels of circulating vitamin D are much less likely to respond to treatment with bisphosphonates, researchers said here.

Women whose mean level of serum 25 hydroxy vitamin D (25[OH]D) was at least 33 ng/mL were almost five times more likely to benefit from bisphosphonates than those whose levels fell below that cutoff (OR 4.53, 95% CI 2.17 to 9.48, P<0.0001), according to Amanda Carmel, MD, of Weill Cornell Medical College in New York City, and colleagues.

In addition, for each 1 ng/mL decrease in 25(OH)D level, there was a 5% decrease in likelihood of responding to treatment (OR 0.95, 95% CI 0.92 to 0.98, P=0.0007), Carmel reported at the annual meeting of the American Society for Bone and Mineral Research.

"The current study is the first to identify a threshold level of 25(OH)D that defines improved outcome to bisphosphonate therapy such that patients with a mean 25(OH)D ≥ 33 ng/mL had a substantially greater likelihood of responding to bisphosphonates," the authors wrote.

"This threshold value of ≥ 33 ng/mL for 25(OH)D is higher than the level considered adequate by the Institute of Medicine report for the general population, arguing that higher levels may be required for specific therapeutic outcomes."

According to coauthor Richard S. Bockman, MD, PhD, the results may help explain discrepancies in responses to bisphosphonates seen in controlled studies compared with the real-world environment.

 

4.   17β-Estradiol Improves Postmenopausal Memory Performance

 

"We found consistently that [CEE] may not be good for the brain, at least in women with increased risk of dementia. And 17β-estradiol had better effects," said Dr. Rasgon.

 

September 19, 2011.  Wroolie, TA et al, "Differences in verbal memory performance in postmenopausal women receiving hormone therapy: 17β-estradiol versus conjugated equine estrogens"  Am J Geriatr Psychiatry 2011 Sep;19(9):792-802. Click here for article

 

Hormone therapy compounds differ significantly when it comes to their effects on cognition in postmenopausal women, especially on verbal memory, new research suggests.

In a cohort study of almost 70 healthy women between the ages of 49 and 68 years who were at risk for Alzheimer's disease (AD), those receiving hormone therapy containing 17β-estradiol showed a significant improvement in verbal memory performance compared with those receiving compounds with conjugated equine estrogen (CEE).

"There is a differential effect of the type of hormone therapy on brain function," principal investigator Natalie Rasgon, MD, PhD, professor of psychiatry and of obstetrics and gynecology at Stanford School of Medicine in Palo Alto, California, and director of the Stanford Center for Neuroscience in Women's Health, told Medscape Medical News.

"We found consistently that [CEE] may not be good for the brain, at least in women with increased risk of dementia. And 17β-estradiol had better effects," said Dr. Rasgon.

She reported that the investigative team is now working on "even more exciting data" that she hopes can be translated into clinical practice.

Don't miss Cynthia Gorney's balanced ground-breaking article all about the beneficial effects of estrogen & the brain--The Estrogen Dilemma, that appeared in the Sunday April 18, 2010 New York Times Magazine.  Click here for the article.  Read more about it in this post.

 

5. Hot Flashes Linked to Higher Cholesterol

 

Several recent studies have linked hot flashes to an increased risk for heart disease, and now new research suggests a link between these menopause symptoms and increased cholesterol.

 

September 21, 2011.  North American Menopause Society (NAMS) 22nd Annual Meeting, paper presented by  Rebecca C. Thurston, PhD, assistant professor of psychiatry and epidemiology, University of Pittsburgh School of Medicine and Lori Mosca, MD, PhD, professor of medicine, Columbia University; director of preventive cardiology, New York-Presbyterian Hospital; past president, American Society for Preventive Cardiology. 

 

Excerpt from Medscape article by Salynn Boyles (to access Medcape articles you need to register). 

Several recent studies have linked hot flashes to an increased risk for heart disease, and now new research suggests a link between these menopause symptoms and increased cholesterol.

The study is being presented in Washington D.C. this week at the 22nd annual meeting of the North American Menopause Society.

Researchers followed more than 3,000 women in their 40s and early 50s for seven years as they transitioned through menopause.

After taking into account other heart disease risk factors they found hot flashes and, to a lesser extent, night sweats to be predictive of higher cholesterol The more hot flashes the women had, the higher their LDL "bad" and HDL "good" cholesterol.

"I think hot flashes and night sweats tell us something about women's cardiovascular risk and health, but it is also likely that this message is quite complex," study researcher Rebecca C. Thurston, PhD, of the University of Pittsburgh tells WebMD.

Columbia University professor of medicine Lori Mosca, MD, PhD, tells WebMD that it is not clear if hot flashes or other menopausal symptoms have any direct impact on heart attack and stroke risk.

One message that is clear, she says, is that menopause is associated with substantial alterations in heart disease risk.

 

6.  More Evidence Links Diabetes and Dementia

 

"We have clearly demonstrated that diabetes is a significant risk factor for the development of dementia, especially of Alzheimer's disease, in (the) general public," said Dr. Yutaka Kiyohara, a professor in the graduate school of medical science at Kyushu University in Fukuoka.

 

September 19, 2011.   Kiyohara, Y, Ohara, T. et al, "Glucose tolerance status and risk of dementia in the community: The Hisayama Study,"  Neurology, 2011 Sep 20;77(12):1126-34.  (click here for the article)

 

Excerpt from HealthDay, Ellin Holohan: 

People with diabetes are at significantly higher risk of developing all types of dementia, including Alzheimer's disease, finds a new study that bolsters previous research connecting the two illnesses.

The study of more than 1,000 people in Japan found that 27 percent of those with diabetes developed dementia, compared to 20 percent of people with normal blood sugar levels.

Further, the study showed that pre-diabetes -- higher than normal blood sugar levels -- also raised the risk of dementia.

"We have clearly demonstrated that diabetes is a significant risk factor for the development of dementia, especially of Alzheimer's disease, in (the) general public," said Dr. Yutaka Kiyohara, a professor in the graduate school of medical science at Kyushu University in Fukuoka.

The study, conducted from 1988 to 2003, is published Sept. 20 in Neurology.

The study followed 1,017 men and women, age 60 and older, who took a glucose test to find out if they were diabetic or pre-diabetic. They were then tracked over an average of 11 years each. In all, 232 developed dementia, either Alzheimer's, vascular dementia, all-cause dementia or another form.

Of the 150 who had diabetes, 41 developed dementia, compared to 115 of the 559 people without diabetes. Among the 308 people with pre-diabetes, 76, or 25 percent, developed dementia.

Even having high levels of sugar two hours after taking glucose was linked to dementia, the researchers said, noting the importance of consistent blood sugar control.

Diabetes affects close to 26 million children and adults in the United States, with 7 million of them undiagnosed, according to the American Diabetes Association. Another 79 million have pre-diabetes. Obesity increases the risk of diabetes, and as Americans become heavier, more are developing diabetes.

While prior research has shown a link between diabetes and dementia, the Japanese study is important because of its size and duration, said another expert.

Another expert noted that diabetes could be connected to dementia because it contributes to vascular disease, disrupting the flow of oxygen to the brain and other organs.

"Diabetes is a major risk factor for vascular disease," said Dr. Spyros Mezitis, a clinical endocrinologist at Lenox Hill Hospital in New York City. "If the blood vessels are not allowing enough oxygen to get to the brain, you can get dementia."

The study will "change the way we practice medicine" and could lead to quicker referral of diabetics to neurologists when they show signs of memory loss or other cognitive problems, he said.

The goal for patients is to avoid the progression of vascular disease and to maintain proper blood sugar levels, he noted.

 

For more on the adverse effects of blood sugar spikes on the brain, click here.

 

7.  Erectile Dysfunction May be Linked with Cardiovascular Trouble--an Independent Risk Factor for Heart Disease, Stroke and Death.

 

"A number of prior individual studies have shown that men with erectile dysfunction are at increased risk for fatal and nonfatal cardovascular events. 

Men with erectile dysfunction should be aware of this significant increase in cardiovascular risk and take proactive steps to adopt a healthy lifestyle and better control their cardiovascular risk factors,"  Dr Greg Fonarow, MD, UCLA, commenting on the article.

 

 September 14, 2011.  Dong, YR, Zhang, YH, Qin, LQ , "Erectile dysfunction and risk of cardiovascular disease meta-analysis of prospective cohort studies,"   J Am Coll Cardiol  2011 Sep 20;58(13):1378-85  click here for the article

 

Excerpt from HealthDay:

Although it is well accepted that cardiovascular disease is a risk factor for erectile dysfunction, it has not been clear whether erectile dysfunction is an independent risk factor for cardiovascular disease, the researchers noted.

"Erectile dysfunction significantly increased the risk of cardiovascular disease, and the increase was probably independent of conventional risk factors," said lead researcher Dr. Li-Qiang Qin, from the department of nutrition and food hygiene in the School of Public Health at Soochow University in Suzhou.

As such, "erectile dysfunction may not only contribute to cardiovascular risk prediction, but also serve as a potential target for cardiovascular disease prevention," Qin said.

The report was published in the Sept. 13 online edition of the Journal of the American College of Cardiology.

For the study, Qin's team culled data on the relationship between erectile dysfunction and cardiovascular disease from 12 studies published between 2005 and 2011 that included a total of 36,744 people and an average follow-up of 4 to 16.2 years. This process, called a meta-analysis, tries to pool data from several sources to tease out a pattern that might not be obvious in a single study.

The researchers found a significant association between erectile dysfunction and the increased risk of cardiovascular disease, heart disease, stroke and death.

In fact, men with erectile dysfunction had a 48 percent increased risk for cardiovascular disease, a 46 percent increased risk for heart disease, a 35 percent increased risk for stroke and a 19 percent increased risk of dying of any cause, compared to men without the condition.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, noted that "erectile dysfunction impacts some million 18 million men in the United States."

Cardiovascular disease and erectile dysfunction share many common risk factors, including diabetes, obesity, smoking, hypertension and high cholesterol, he said.

Read more here: From the New York Times: For a Common Male Problem, Hope Beyond a Pill. Diet, Exercise, & Lifestyle Changes Improve E.D.


 

Crazy Busy Between Now & Mid-October

I'm not sure how much I'll be blogging in the upcoming weeks--with Rosh Hashanah/Yom Kippur starting tomorrow night--and soon after I'll be traveling out-of-town to help my kids with the arrival of grandchild #2. Woo Hoo!

In between work--I'll be busy cooking for the holidays, and planning & prepping meals to stock my kids' fridge!  I want to spend time playing with the grandbabies--not stuck in the kitchen!

If I have any free time I just might be able to sneak in a post or two!  No promises.

Lab Rat's written a terrific post on how to grow sprouts in your kitchen.  I've got new recipes to share, the update on my new strength-training routine, more hot-off-the-press health news, and my promised follow-up post with my favorite tips, tools, snacks & pantry staples for a simplified plant-based kitchen!

 

Posted on September 27, 2011 at 08:13 AM | | Comments (8) | TrackBack (0)

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September 05, 2011

Saturday Morning Heart to Heart Girl Talk with My Sister-in-Law - Triglycerides, Esselstyn Diet Success, Restaurant Insanity, Molten Lava Cake, Tortilla Soup - and of course, the Grandkids, Kids, & Husbands

 
Telephone

Photo by Vincent Van Der Pas


"When triglycerides go up over 100 we start making abnormal forms of cholesterol--the small dense LDLs that are atherogenic and penetrate much more rapidly into the arteries than normal large LDLs. 
 
When triglycerides start going up--and the changes start around 80-100--nearly everyone with triglycerides over 100 is making significant amounts of small dense atherogenic LDL--above 150 almost all LDL particles are small dense and atherogenic." 

-Dr. Patrick E. McBride, Professor of Medicine and Family Medicine, University of Wisconsin, and a member of the Expert III NCEP Panel setting cholesterol guidelines-

 

 

If you received this post via email, click here to get to the web version with all the links.

On Saturday morning, my sister-in-law and I FINALLY had a chance to catch up.  

We talked for an hour staight--which is nothing for us--we'd barely scratched the surface of what we could cover--but we both had to call it quits to get on with the rest of of the stuff on our To-Do Lists.

She had some pretty good news to share--and I asked her if it was OK if I shared it with you.  She said, "Sure! Go ahead."   So here's what we talked about....

 

What's Up with My High Triglycerides?  Help!

 

Here's the back story.

Exactly, one month ago my sister-in-law texted me a cryptic message, "Call me when you have a chance.  Need your opinion."

Turns out, she'd had her annual gyno exam.  Her doc had taken her lipids, and she' had just found out that her total cholesterol was too high--and her triglycerides were off-the-charts high.

 

She: "How can that be?  I really do eat healthy.  I exercise.  My doc wants me to make an appointment with a cardiologist ASAP, but I don't want to go on statins, or take anything for the triglycerides.  Most of my other numbers are OK--the LDLs & HDLs--but the triglycerides are sky-high.  I'd really like to go 100% on the Esselstyn diet first  & see if I can get those numbers down."


Me:  "Well, don't get mad at me for saying this--but I've been there myself--thinking I'm eating a healthy diet, when I'm really eating "a healthy diet at home"...in addition to a load of crap out-of-the-house!  

I know you make healthy meals at home--but it's probably all the rest of the stuff you're eating.  The restaurants, the traveling, the cookies, cakes, & pastries your friends make, the lack of exercise when you're traveling, the wine & rum, the sugar, the dinners at friends', the crusty French bread, yada yada yada.  It all adds up--and bottom line--if you're taking in more calories than your body needs--you can end up with high triglycerides!

Look, I never would have tried the Esselstyn diet 100% if he hadn't challenged me to do it.  You won't know if it works until you do it 100%.  Once I did it 100% & saw the results--I was convinced.

High triglycerides, are bad news.  Definitely see the cardiologist. But, sure-- try the diet first to see if it can make a difference for you.


She:  I've already downloaded Esselstyn's book on my Kindle.  Can you send me any other info you might have that will help?  I've got just 2 1/2 weeks to try this out, before I go out-of-town with my friends.  I know I won't be able to do it 100% on vacation--just not possible--so I'm going to see if I can get a cholesterol test before I leave on vacation to at least see if I'm on the right track. Before I see the cardiologist.

Oh, I've been reading up on triglycerides--but send me anything you might have on the blog that would help.


Here's what I emailed her:


Here's one of the posts I've written about on triglycerides--but this one sums it all up.  NOTE:  In April the ranges for normal all moved downward.  Now, the recommendation for the normal range is at 100 or below (no longer below 150).  But as you'll read, it's best to be at 80 or below. You want to make sure you're making light fluffy LDLs, not the small dense kind.  You might request the NMR particle test.  And here's the link to the new American Heart Association Scientific Statement recommending that triglycerides ought to be at 100 or below--not 150.

You want me to ask Dr. Esselstyn what he suggests you do?

Good luck!

Love you!


My note to all of you:  Please read that post I sent my sister-in-law about triglycerides.  It will tell you everything you ever wanted to know about these bad-boys.  They're an independent risk factor for strokes & cardiovascular disease.  If you've got a lot of belly fat--you probably have high triglycerides.  If you're eating more calories than your body can burn off--you probably have high triglycerides.  To read even more (yeah right!) about the triglyceride stroke/heart connection, click here and here and here.


How Strange is This?  The day after I sent the email to my sister-in-law, Dr. Esselstyn just happened to call me at work with a library question.  Of course, I asked him for some words of wisdom for my sister-in-law & for high-triglycerides in particular.  Darn, I no longer have my notes--but here's what I remembered he said:

  • Cut out the sugar--all kinds!  (my note: be sure to read this and this)
  • Cut out alcohol
  • Cut out the white foods--refined flours, pastas, breads, rice, crackers, etc. If high triglycerides are a problem for you--stick to just eating whole grains--and skip foods made with whole grain flours, like breads & pastas.  Even whole grain flours can raise triglycerides in folks who are overweight and insulin-resistant.  Think about it--flours of any kind are "processed" & digest too quickly.  Instead eat quinoa, wheatberries, hulled barley, steel-cut oats.  Flourless sprouted breads, like the Ezekiel brand, are a better choice if you need a bread.
  • Remember!  Green leafy vegetables are the Main Event when it comes to making blood vessels "heart attack proof".  Load up on vegetables over grains!
  • No fruit juices--and be careful not eat too many fruits, either, if you have high triglycerides.  Stick to the ones with the lowest sugar content.  (my note: the fruits lowest in fructose include strawberries, berries, cantelopes, grapefruit, peaches)  Source: AHA statement quoted on CardioBrief
  • Avoid smoothies made with fruit!  It can cause a rapid rise in blood sugar for some people.  I see it happen a lot!
  • Avoid dried fruit--too much sugar!  Especially high sugar fruits like dates & raisins.

 

Oh heck--I really really don't want you to miss the Triglyceride Post I emailed to my sister-in-law--so, just in case you don't click that link--I at least want to make sure you get some of the key points:


In A Nutshell--Here's What Dr. Patrick E. McBride is Saying About Triglycerides

  • If your triglycerides are under 80 you are making "normal large" LDLs that are not very atherogenic (think atherosclerosis; arterial plaque; hardening of the arteries)
  • When triglycerides are over 150 (there are just too many particles floating around with no where to go) they briefly get inserted into the LDLs and change the LDLs into "small dense atherogenic" particles.
  • Stealth LDL: That's what you call what was once a normal LDL particle that's been penetrated by free-floating triglycerides.  When triglycerides are too high they are able to change the LDL into "small dense dangerous" LDL that oxidizes very easily (a bad thing) and penetrates rapidly into the arteries. Note: Triglycerides are not supposed to penetrate the LDLs!!
  • Normal LDL: It's difficult for normal LDL (large & fluffy) to penetrate into the wall of an artery!
  • When triglycerides are between 80-100 you start to  make abnormal LDL.  Some of it starts changing into the "small dense atherogenic" variety at this level.  (If changes start happening over 80--it looks to me like the only safe triglyceride number is under 80!)
  • When triglycerides are over 100--according to Dr. McBride--you've turned the corner & "are making at the very least, a significant amount of "small dense" LDL."
  • When triglycerides are above 150, almost all of the LDL particles become "small dense atherogenic".
  • Dr. McBride served on the III NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults that set the guidelines for triglycerides (and cholesterol) back in 2002.  He advocated for the normal level to be under 100--and he strongly believes that the current level will go down to 100 when the next guidelines come out.  Note: in April 2011 the AHA issued a Scientific Statement recommending the new normal be under 100.  Find that here.
  • According to Dr. McBride, if you have abdominal obesity, the chances are greater that you are producing the abnormal dangerous "small dense" form of LDL.
  • If you overconsume sugar, soda pop, saturated fats, trans fats, refined carbohydrates, and "fried apple pies"--and you are consuming more calories than you need--your body doesn't know what to do with all that junk--and you end up with lots of rich triglycerides--that are very inflammatory and very atherogenic--floating around--just looking for an LDL to penetrate and turn it into "small dense dangerous" LDL!

 

Sister-in-Law Success! 

 

Before my sister-in-law went on her week vacation with her gal pals, she wisely had her blood drawn for a cholesterol test.  She'd been on the Esselstyn diet for just 2 1/2 weeks--eating no-fat, no meat, no cheese, no-oil, no refined grains.

She knew it wouldn't be as good as if she'd been on the diet for 4 weeks--but at least she's get some idea if it could improve her lipids.

 

Test results:  Her total cholesterol dropped 100 points!  Amazing! Full disclosure: for some unknown reason, the lab only measured her total cholesterol--not what she really needed--a full lipid panel.  But she figures the triglycerides & LDLs must be going down if her cholesteol levels came down so much in just 2 1/2 weeks.  She'll be following up with a full lipid panel.

Other good news:  In spite of her one week of transgressions on vacation--she's back to the Esselstyn diet--and she's losing weight.  Best of all, she's losing belly fat!  She's committed to stick with it. She'd rather lower her triglycerides with diet instead of drugs.  Besides, only diet can help reduce weight.

 

What My Sister-in-Law is Up Against.  She Lives in the Southern "Stroke Belt", Her Friends Think Health is All About Genes, Not Diet & Everyone Likes to Eat Out

 

She's swimming against the stream in her neck of the woods.  She's the odd girl out in her social circle.

Everyone loves butter, meat, cheese, pastries, fried foods, good old Southern cooking, and eating out.

Lately, everyone's complaining about being so forgetful.  They thinks it just normal aging. 

Uh??  Think again, folks!

Check out this "hot off the press" article published online in Stroke, Sept. 1, 2011   Buchman, AS etal "Cerebrovascular Disease Pathology and Parkinsonian Signs in Old Age".  It's summarized in the NPR Blog, Shots:

 

"Old people who don't have signs of cardiovascular disease still may have suffered microscopic strokes that don't show up on conventional tests. The small strokes may impair their ability to walk, balance and function just the same.

Scientists examined the brains of 418 priests and nuns after they died. The researchers found that one-third of the brains that had seemed normal using conventional tests while the people were alive actually had damage to tiny blood vessels. The damage was so slight it was impossible to see without a microscope.

The people whose brains had these tiny signs of hardened arteries and stroke were most likely to have had shuffling gait and other movement problems while they were still alive."

 

If you've been eating the standard American diet--and you're eating out a lot, there's a good bet that what we take to be the "normal forgetfulness of aging"--isn't exactly normal.  It could be teeny weeny imperceptible strokes.  Now that's one scary thought!

 

"Dr. Megan C. Leary of UCLA examined over 5,500 MRIs of the brains of 50 year olds & found many had tiny white spots that indicated that they had unknowingly experienced tiny, imperceptible strokes.  These "brain attacks" have the same history and cause as heart attacks.   See "Annual Incidence of First Silent Stroke in the U.S" Cerebrovasc Dis 2003;16(3):280-5.

According to Leary, "'Silent strokes' are epidemic in this country.  While they occur in parts of the brain where they don't cause symptoms right away, the word 'silent' should be put in quotes, because their effects accumulate over the years.''

While a single silent stroke may have no impact, repeated ones lead to memory lapses, mood problems and difficulty walking. They are also a sign that people are especially prone to full-blown strokes.

Keep on eating the same way at age 60, 70, & 80 and there's a good chance that those tiny strokes will add up to increasing memory lapses, and progress on to dementia--depending upon what part of the brain has been affected. 

What's good for the blood vessels of the heart, is good for the blood vessels of the brain."

Dr. Caldwell Esselstyn, Jr., Prevent & Reverse Heart Disease lecture 6/18/2010. see also: The Rotterdam Scan Study;  "Silent Brain Infarcts and the Risk of Dementia and Cognitive Decline," New England Journal of Medicine 2003 Mar 27;348(13):1215-2; "Silent Brain Infarcts: a systematic review,"  Lancet Neurology 2007 Jul;6(7):611-9.

 

As for all that rich Southern cooking--forget about it!  It's killing brain cells and giving the South a new claim to fame:  It's known as The Stroke Belt. 

The "brain-damaging suspects" are likely to be the much-loved traditional Southern diet of fried, salty, & fatty foods along with too little exercise--all of which contribute to hypertension, excess weight, & diabetes--the biggies responsible for stroke risk.

I posted about the brand new REGARDS Study, the Stroke Belt & how the Southern diet is affecting cognitive impairment on July 26, 2011.  No need to repeat what I wrote, just click here to refresh your memories.

 

Two of my favorite quotes about the REGARDS study:

 

"This is a very strong alarm signal.  [The finding suggests that] if you want to keep your marbles, you need to control your blood pressure, excessive weight and other risk factors for stroke."  

Dr. Gustavo C. Roman, the head of the neuroepidemiology section of the American Academy of Neurology, commenting on the article.

[Problems like high blood pressure and diabetes are likely to be "affecting  blood flow to the brain, even if it's not causing a visible stroke.  An undersupply of blood can also cause problems with brain cells that lead to cognitive decline."  

Dr. Kenneth Langa, a professor of Internal Medicine at the University of Michigan, commenting on the article.

 

Restaurant Madness - From "Cook This, Not That"

 

My sister-in-law's friends like to eat out.  Who doesn't?   It's nice to have someone else do the cooking. 

But, once you really know what's in all that restaurant food--most of us will run back to our own kitchens.

Unfortunately, twice a week my sister-in-law has a pretty much mandatory "luncheon meeting" at a restaurant with her business partner.  Sort of non-negotiable. 

Last week, on my weekly public library run I picked up one of those "Cook This Not That" books.  OMG!  I started reading it before I went to sleep--and I couldn't stop interrupting my husband's own reading with, "Listen to this!"   "OMG!  Listen to this one--it's even worse."  

The book shocked me!  No wonder most Americans are overweight.

We haven't a clue what's in that restaurant food--so a big "Thank You" goes out to David Zinczenko & Matt Goulding for collecting all this incriminating nutritional info.  I suspected it--but I really didn't know it was that bad.

And to think how much I used to love Molten Chocolate Lava Cake.  Never again!

 

Chilis-molten-lava-cake

Chili's Molten Lava Cake - 1,070 calories, 51 g fat, (26 g saturated), 143 carbs

 

No wonder restaurants don't want to post the nutritional info on their menus. 

These aren't the worst offenders--but here's a sampling of some of the meals that even health-conscious folks might consider ordering.

 

Marie Callender's Spanish Omelette:  1,550 calories, 78 g fat (25 g saturated), 2,980 mg sodium

Baja Fresh Chips and Gaucamole:  1,340 calories, 83 g fat (8 g saturated), 950 mg sodium

California Pizza Kitchen Tuscan Hummus with pita:  861 calories, 4 g satuated fat, 1,562 mg sodium

Ruby Tuesday Buffalo Shrimp Quesadilla:  1,465 calories, 89 g fat, 3,528 mg sodium

Houlihan's Fire Grilled BBQ Salmon Salad:  1,182 calories, 61 g fat (9 g saturated), 1,719 mg sodium

T.G.I. Friday's Santa Fe Chopped Salad:  1,800 calories

Panera Bread Tuna Salad on Honey Wheat Sandwich:  750 calories, 47 g fat (9 g saturated), 1,130 mg sodium

Chipotle Grilled Chicken Fajita Burrito:  870 calories, 30 g fat (13 g saturated), 1,940 sodium

Just for kicks, borrow a copy of this book from your library--or check out the worst vegetarian restaurant meals  (check out the side-panel on the left) and then click through the slideshow of the 20 worst new foods in America.

 

  Cook This!  Enlightened Appetite for Reduction Tortilla Soup

 

IMG_5159

Enlightened Isa's "Appetite for Reduction"  Tortilla Soup - 223 calories, 1.5 g fat (0 g saturated), 8.7 g fiber

 

 

No conversation with my sister-in-law is complete without sharing recipes--the new finds-that-we've tried out--and loved!

Funny, how she is always trying recipes that I never even noticed--even though we both share a lot of the same cookbooks.  I'm definitely going to reap the benefits of her expert cooking now that she's going Esselstyn.

She:  "Have you tried Isa's Tortilla Soup in Appetite for Reduction?  We all loved it.  But I cut the jalapenos down to just one."

Me:   "Nope.  I never even noticed it in the cookbook.  But I'll check it out as soon as I hang up!"  

And I did, later that day.  A big winner.   Here's my enlightened version.

It looks like a stew or a chili--but it's a soup.  Hearty, spicy, and a big one-bowl meal.

 

Appetite for Reduction Tortilla Soup---My Enlightened Version

click here for the recipe on one page

Serves 6 generously.  Add a salad & an ear of corn for a terrific meal!

 

Ingredients:

1 medium onion, chopped (Isa used a small one)

1 jalapeno, seeded & sliced thinly (Isa says use 2)

1 poblano pepper, seeded & chopped into 1/2 inch pieces (this is the large dark green one--ask your grocer--I had to)  OK to use a sweet green pepper, but go with the poblano!

4 cloves garlic, chopped

(Isa also recommended 1/4 tsp red pepper flakes.  I left these out to see if the soup needed it--and it was hot enough without them--and I like heat!)

1 tsp salt  (optional, always)

28 ounce can of crushed Glen Muir Fire-Roasted Tomatoes

3 cups of low-sodium vegetable broth (plus extra for sauteeing the vegetables)

4 ounces of fresh small corn tortillas--bake or toast these until they are crisp.  Watch them carefully so they don't burn.   (Isa uses 4 ounces of baked corn tortilla chips)

1 tablespoon ground cumin

1 (15 ounce) can of pinto beans, drained & rinsed

1 cup of frozen or fresh corn.  (I like using Trader Joe's frozen Roasted Corn)

1/2 cup chopped fresh cilantro, plus extra for garnishing

Juice from 1 juicy lime

 

Preparation:

1.  Preheat a 4 quart soup pot over medium high heat.  Dry saute the onions, jalapeno, & poblano peppers until the onions are translucent, about 5 minutes.  Add a little vegetable broth if the onions start to stick or dry out--to deglaze the pan.

2.  Add the crushed tomatoes, the 3 cups of vegetable broth, and the cumin to the pot.  Mix well.

3.  Crush the crisped tortillas into crumbs (some bigger pieces are OK) & add about 1/2 of them to the pot--reserving the rest for garnish.   (I ended up adding all of them to the pot, because I didn't read the directions carefully & it thickened the soup, nicely)  You want the crumbs to "melt" into the soup.

4.  Cover, & bring to a boil.  Lower the heat to a simmer, add the beans, corn, & cilantro.  

5.  Simmer for 5 more minutes.

6.  Add the lime juice, taste for seasonings.

7.  Ladle soup into bowls, & top with remaining tortilla crumbs & remaining cilantro.

 

Nutrition Info:

1/6th of the recipe

 

 

 

Nutrition Facts
Enlightened Appetite for Reducti
The Best Tortilla Soup
Serving Size: 1 serving
Amount Per Serving
Calories 223
Total Fat 1.5g
      Saturated Fat 0g
      Trans Fat 0g
Cholesterol 0mg
Sodium 408mg
Carbohydrate 46.9g
      Dietary Fiber 8.7g
      Sugars 12.4g
Protein 8.6g
Vitamin A 48% Vitamin C 172%
Calcium    8% Iron 15%

 

 

 

 

I'd love to hear about your favorite Appetite for Reduction recipes!  

Anyone have some suggestions for "safe foods" when you absolutely have to eat out?

 

 


 

 

 

 

 

 

 

 

Posted on September 05, 2011 at 11:50 AM | | Comments (14) | TrackBack (0)

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June 21, 2011

Could This Be the Alzheimer's/Dementia Prevention Diet? It's the Ultimate Food Fight Face-Off - The VA Puget Sound Study Shows How a Low Fat Low-Glycemic Diet Improves Markers for Alzheimer's Disease in Just Four Weeks

Dementia

 

"Diet can have a very significant impact on some of the pathological markers of Alzheimer's disease.  I think we're starting to see in epidemiologic studies a connection between diet and brain aging, but I think our study is the first that has really shown, in an experimental fashion, that by creating a very carefully controlled diet you could show these very significant effects."

-Suzanne Craft, PhD, associate director of the Geriatric Research and Clinical Center at the Veterans Affairs Puget Sound Health Care System in Seattle, "Diet Intervention and Cerebrospinal Fluid Biomarkers in Amnestic Mild Cognitive Impairment,"  Archives of Neurology  68(6):743-52, 2011-

 

"One in 3 of us will have a stroke, dementia, or both, unless we improve prevention. 

Although cerebrovascular disorders and Alzheimer disease tend to occur together, they are studied apart and [too] late in their evolutions, when less or little can be done.

The commonest forms of stroke are silent, and Alzheimer disease begins decades before any symptoms appear.  Moreover, epidemiological studies show that strokes and Alzheimer disease occur together and pose risks for each other, and clinical, pathological, and experimental studies suggest that they may also interact."

-Vladimir Hachinski, MD, DSc, Dept. of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, "Stroke and Alzheimer Disease.  Fellow Travelers or Partners in Crime? Archives of Neurology  68(6):797-98, 2011- 

 

"*Dr. Megan C. Leary of UCLA examined over 5,500 MRIs of the brains of 50 year olds & found many had tiny white spots that indicated that they had unknowingly experienced tiny, imperceptible strokes.  These "brain attacks" have the same history and cause as heart attacks.   *(correction made 6/25/11)   See "Annual Incidence of First Silent Stroke in the U.S" Cerebrovasc Dis 2003;16(3):280-5.

 According to Leary, "'Silent strokes' are epidemic in this country.  While they occur in parts of the brain where they don't cause symptoms right away, the word 'silent' should be put in quotes, because their effects accumulate over the years.''

While a single silent stroke may have no impact, repeated ones lead to memory lapses, mood problems and difficulty walking. They are also a sign that people are especially prone to full-blown strokes.

Keep on eating the same way at age 60, 70, & 80 and there's a good chance that those tiny strokes will add up to increasing memory lapses, and progress on to dementia--depending upon what part of the brain has been affected.  What's good for the blood vessels of the heart, is good for the blood vessels of the brain."

Dr. Caldwell Esselstyn, Jr., Prevent & Reverse Heart Disease lecture 6/18/2010. see also: The Rotterdam Scan Study;  "Silent Brain Infarcts and the Risk of Dementia and Cognitive Decline," New England Journal of Medicine 2003 Mar 27;348(13):1215-2; "Silent Brain Infarcts: a systematic review,"  Lancet Neurology 2007 Jul;6(7):611-9.

 

 If you received this post via email, click here to go the website with all the links.

The VA Puget Sound Study on Diet & Alzheimers/Dementia

 

Frankly, I worry more about the health of my brain than that of my heart.  The VA Puget Sound study is one of the most exciting stories that I've read this month.  But, I'm a sucker for any study that points to ways to prevent Alzheimer's or dementia.

This is the first randomized controlled trial that shows how a low fat diet that's also high in the kinds of low-glycemic foods that can keep our blood sugar steady (think oats & beans & greens), just might turn the Alzheimer's/Dementia ship around--provided that the dementia tipping point hasn't yet been reached.  "Diet Intervention and Cerebrospinal Fluid Biomarkers in Amnestic Mild Cognitive Impairment,"   just appeared in the June 2011 issue of the Archives of Neurology.

Want to learn more about the Glycemic Index?  What's high?  What's low?  Go to the official website, here.

 

Bottom Line, Here's What The Study Found:

A diet that's low in fat, especially saturated fat, with lots of low-glycemic foods, like whole grains and vegetables that keep blood sugar & insulin levels steady, can literally change the levels of the specific substances found in the cerebrospinal fluid that are associated with the development of Alzheimer's.  

This diet not only improved many of the biomarkers for Alzheimer's, but it also improved scores on the   delayed visual memory test--and did so in only 4 weeks.  Makes me wish the study lasted much longer.

On the other hand, the diet that was high in fat & high glycemic foods increased the markers that would put one on the road to Alzheimer's--especially for healthy people.  It also raised insulin levels, cholesterol/lipid levels, and saw performance declines on the delayed visual memory recall test in healthy subjects.  No contest.

For years now we've heard that being overweight, having high cholesterol, type-2 diabetes, a big belly,  insulin resistance, metabolic syndrome, and eating a high-fat-refined-carbohydrate diet upped the risks for dementia &/or Alzheimers as we got older.  No news flash here.

Plenty of studies have already pointed the finger squarely in the direction of saturated fat, sugar, & refined carbs as the culprits in dementia--but up until now, no one has conducted a randomized controlled trial to carefully compare how high fat/high-glycemic versus low fat/low-glycemic diets affect a whole list of biomarkers for Alzheimers.

 

What's Unique about This Study?

 

It looked at the whole-diet--not just individual nutrients or individual foods

Instead of focusing on one single food or nutrient--like fish, olive oil, blueberries, omega-3s, or sugar--the VA Puget Sound researchers decided it was time to look at a "whole diet approach"---how people really eat.  Previous studies of specific foods haven't found anything conclusive when it comes to influencing Alzheimer's risk.

This study compared how the  So-Called Good Reputation Foods (low fat & low-glycemic foods) stack up against the So-Called Bad Reputation Foods (high fat & high-glycemic foods, which are the simple carbs like sugar & white flour).   Kind of like a food fight face-off between steak, butter, french fries, Coke, white bread & cookies, matched up against fish, beans, salad, oatmeal, blueberries and whole wheat bread.

Home delivery of meals

The VA researchers weren't taking any chances with their study.  They didn't depend on people remembering what they ate--they actually delivered the precise meals to their research subjects twice a week--so they could make sure everyone was eating the same foods.

A Complete Physical!  Pre- and Post-Study Comparisons of Alzheimer's Markers in the Cerebrospinal Fluid, Lipid Levels, Blood Glucose & Insulin Levels, and Memory/Cognition Tests

They compared participants who were healthy with those who already had pre-Alzheimer's Amestic Mild Cognitive Impairment (aMCI)--analyzing their results after 4 weeks of following either a High-Fat-High- Glycemic Diet or a Low-Fat-Low-Glycemic Diet. 

They did pre- and post-study measurements of everyone's insulin, glucose & lipid levels because these are all Alzheimer risk factors.   They also ran pre- and post-study cognitive & memory tests.  

The Importance of Measuring the Cerebrospinal Fluid Markers of Alzheimers

But the most important part of the study was the pre- and post- comparisons of the effects of the two different diets on the cerebrospinal fluid markers of Alzheimer's disease.  The researchers used spinal taps to analyze participants' cerebrospinal fluid--the clear liquid that bathes the brain and can give a snapshot of brain health.  Here's what they looked at:

  • Beta-amyloid (beta-amyloid 42) in the cerebrospinal fluid--this rises as we age--that is, until amyloid plaque starts to deposit in the brain--at which point the levels counterintuitively start to decline.  This is a complicated concept, that can best be explained by the drawing below.  If you're healthy, and you improve your diet, a decrease in cerebrospinal fluid (CSF) levels of beta-amyloid would means you're on the right track towards avoiding Alzheimer's.  But, if you've already reached that tipping point of pre-dementia, where plaque has started to deposit, a decrease in CSF beta-amyloid levels means you're heading towards full-blown Alzheimer's.  However, even at this point, if you manage to improve your diet, as some aMCI participants did in this study, an increase in CSF beta-amyloid 42 levels could mean you're actually moving back towards the tipping point--and to a healthier state.  Very confusing stuff!

AB42 accumulation

Model of hypothetical trajectory of brain & cerebrospinal fluid (CSF) beta-amyloid 42 accumulation with increasing Alzheimer disease symptoms and pathologic features.  Figure 3, Arch Neurol 68(6):749, June 2011.

  • Cerebrospinal fluid levels of insulin.  This plays an important part in many brain functions that are relevant to Alzheimers--like forming & maintaining synapses.  Reduced central nervous system insulin is a marker for Alzheimer's--and brain insulin is compromised by persistent high insulin states, a high fat diet, & a high-fructose diet.
  • Apolipoprotein E.  This is a protein that helps clear out beta-amyloid--the culprit in beta-amyloid plaque formation, the hallmark of Alzheimer's.  When it comes to APOE, increased levels are beneficial--decreased levels point towards Alzheimer's.
  • CSF-F2-isoprostanes. This is a marker for oxidative damage to the central nervous system (yes, the brain) caused by free radicals.  The CSF-F2-isoprostane levels increase in both Alzheimer's and pre-dementia-and dietary fat can adversely affect their levels.  Decreased levels are a good sign.

 

And the Envelope Please!  The Contestants & the Results.

 

Who was in the study?

49 adults participated, including 20 healthy individuals (the control group), with an average age of 69.

29 participants had aMCI (amnestic mild cognitive impairment--a precursor to Alzheimer's), with an average age of 68.  aMCI was determined through a comprehensive neuropsychological battery. 

All of the study participants were free of neurologic and psychiatric disorders, unstable cardiac disease, alcoholism, diabetes, liver or kidney or pulmonary disease.

No one was taking cholesterol-lowering medications.

What are the details of the diets in the study?

The participants followed their assigned diets for 4 weeks.

The diets were carefully measured, analyzed, & delivered twice a week to the participants.  These were designed to maintain each person's weight--which took out any effect that the weight loss variable might have on the Alzheimer's markers.

The LOW Diet:  This was a low-fat, low-glycemic diet.  Specifically, 25% fat, less than 7% saturated fat, 55-60% carbohydrates, with a glycemic index of less than 55, and 15-20% protein.   Not exactly low-fat--but lower than average.

The HIGH Diet:  This was a high-fat, high-glycemic diet.  Specifically, 45% fat, with 25% saturated fat, 35-40% carbohydrates with a glycemic index of greater than 70, and 15-20% protein.

Unfortunately, we don't know the specific foods used in this study, nor their micronutrients--something I would be very interested in knowing.

Diet adherence was high.

Study participants were randomized with 24 individuals following the HIGH Diet; and 25 individuals following the LOW Diet.

What measurements were taken pre- and post-study?

  • Tests of immediate & delayed memory, executive function, verbal fluency, and motor speed.  The only memory test that was affected after 4 weeks was the delayed visual memory.
  • Oral glucose tolerance test
  • Tests of blood insulin (AUC), blood glucose levels, & lipid/cholesterol levels
  • The Alzheimer biomarkers found in the cerebrospinal fluid: CSF AB42, AB40, tau protein, CSF-insulin, F2-isoprostanes,  & apolipoprotein E.
  • NOTE:  No effects were seen in the AB40, tau protein, or p-tau levels in any of the groups.

The Results?

For the Healthy Adults

The HIGH fat/High GI Index

"In healthy adults, the HIGH fat/high-glycemic diet increased levels of beta-amyloid and other markers of inflammation and free radical damage in the spinal fluid, suggesting that the high amounts of unhealthy fats and wide swings in blood sugar from the high-glycemic diet may be moving the brain toward changes associated with Alzheimer's." 

Cholesterol/lipids & blood insulin levels all increased.  HDL levels, however, increased as fat increased.

The results on the delayed visual memory tests declined.

The LOW fat/low GI Index

The LOW fat/low-glycemic diet, however, decreased those levels of beta-amyloid, insulin, and F2-isoprostanes, and increased levels of apolipoprotein E, suggesting a protective effect. 

Cholesterol/lipids, glucose, & insulin levels all decreased--and improved over baseline. HDL decreased because the fat decreased. Results on the delayed visual memory tests improved over baseline.

All excellent news, as far as I'm concerned. 

Can't help but wonder what improvements might be seen on the low-fat/low glycemic diet over time.

The AMCI Pre-Alzheimer's Group

In those participants who were diagnosed with aMCI, who had already begun to have some memory or brain impairments, the results were more complex. 

The HIGH fat/High GI Index

Those on the HIGH fat/high glycemic diet, saw little changes in the Alzheimer's biomarkers. 

Dr.  Suzanne Craft, the study author says, "That's possibly because they've already got a very pathological process going on, and such a short study wasn't going to to make things much worse.

However, their cholesterol/lipid levels increased far more than those of the healthy subjects who were on the HIGH Diet--especially their LDLs and total cholesterol. 


The LOW fat/low GI Index

Those who were on the low-fat diet saw increases in the levels of beta-amyloid in their spinal fluid. 

Researchers say other studies that have looked at changes in beta-amyloid as Alzheimer’s disease progresses have observed a tipping point, where levels rise until a critical level is reached and plaques begin to form. When that happens, the disease accelerates, more plaques form in the brain, and levels of beta-amyloid in spinal fluid drop.

They say the rise in beta-amyloid seen in adults with cognitive impairment on the low-fat diet may indicate that the brain is moving away from the tipping point of plaque formation and back toward a healthier, more normal state.

People with early memory loss saw other markers of oxidative damage drop on the low-fat diet, and their scores on some measures of memory improved after the study, though the changes were subtle.   

They also saw small improvements in their blood insulin & glucose levels, and substantial improvements (decreases) in their cholesterol/lipids--especially in their LDLs & total cholesterol.

Taken together, researchers say their results show that high-fat, high-sugar diets can have consequences for the brain.

“Exposing your body and your brain to this type of diet over a very long period of time is going to put you on the path to Alzheimer’s disease,” Craft says. (WebMD)

 

The Secret of This Diet's Success?  Does a Low-Glycemic Diet Have the Added Benefit of Boosting Nitric Oxide?

 

After reading this study I'm even more convinced of the benefits of eating a no-added fat low-glycemic plant-based diet.

If you think that the prevention of Alzheimers/Dementia is beyond your control--this study just might change your mind!  Combine this study with what we learned from the  Mayo Clinic's recent research on how a steady supply of nitric oxide can protect the brain from plaque formation &  Alzheimer's--and we just might have a prescription for a "NO (nitric oxide) Dementia Diet".  

What keeps our nitric oxide supply kicking?  Plenty of oats, leafy greens like kale, chard, & collards--and plenty of exercise, too!  And what foods also happen to be low-glycemic?  That's right.  The same ones that also help boost our nitric oxide supply. 

Could this help explain why the VA Pugent Sound researchers found that their low-fat low-glycemic diet had such a positive effect on the Alzheimer's biomarkers?  To learn more about the nitric oxide Alzheimer's connection read: Mayo Clinic Researchers Discover the Nitric Oxide Connection to Brain Health, Alzheimer's, and Cognitive Impairment.  Better Keep Your Endothelial Cells Healthy with Diet & Exercise!

How do the low-glycemic nitric oxide-boosting foods benefit our brains?

  • They keep insulin levels steady--preventing the "up & down" blood sugar spikes that damage the "dentate gyrus", which is within the hippocampus--that's the part of the brain responsible for forming memories. Small, SA et al, "The brain in the age of old; the hippocampal formation is targeted differenially by diseases of late life,"  Annals of Neurology 2008 Dec;64(6):698-706
  • Even slight elevations of blood sugar--less than those seen in type-2 diabetes can cause memory decline.  Because blood sugar tends to rise as we age--even in healthy people, it makes Small's study a wake-up call to take steps to keep the blood sugar stable.
  • Even if you don't have type-2 diabetes, blood glucose levels tend to rise as we grow older. Small recommends physical exercise, diet or drugs to improve glucose metabolism and help avert the cognitive slide that occurs in many of us as we age.
  • The nitric oxide boost from low-glycemic foods keeps blood vessel walls healthy (even in the brain), resists atherosclerotic plaque formation, prevents amyloid plaque formation in the brain, lowers blood pressure, relaxes blood vessels, and helps to reduce cerebrovascular risk factors.  According to Dr. Randolph Schiffer, the head of the Cleveland Clinic's Ruvo Center for Brain Health, cardiovascular diseases & Alzheimer's share similar blood vessel pathologies.  Read more here.

How a low-fat diet benefits our brains

  • Low intake of saturated fats is associated with a reduced risk of Alzheimer's and its precursor, amnestic mild cognitive impairment (aMCI).
  • "Elevations in LDL cholesterol and total cholesterol concentrations have been demonstrated in early Alzheimer's--with cholesterol increases occurring in conjunction with greater Beta-amyloid disease."
  • "Diets high in saturated fat impair blood-brain barrier function; in a rodent model, evidence suggested that high-saturated fat diets may allow delivery of cholesterol and Beta-amyloid [combined] with lipoproteins from the periphery into the central nervous system."
  • A low-fat diet reduces the free radical injury to the blood vessels--and reduces the oxidative damage to the central nervous system.  Cerebrospinal fluid markers for oxidative stress naturally increase as we age, reflecting accumulated oxidative stress--but in the VA Puget Sound study, the low-fat low-glycemic diet was able to reduce the biomarkers of oxidative stress in the brain.

 

Study limitations:

1.  The study was designed to keep the participant's weight stable, not reduce it.  The researchers speculate that weight change might have produced different results. There are multiple studies linking belly fat & obesity with a higher risk of dementia.  One study of middle-age people (44-66 year old) found "that the obese tended to have smaller, more atrophied brains than thinner people."   I'm betting that a healthy diet that also promotes weight loss would have shown even greater improvements in the Alzheimer biomarkers.

2.  The study only lasted for four weeks. Because of safety precautions, the length of time that the researchers would allow the participants to stay on a high fat/high glycemic diet had to be kept short.  Longer exposure to such a diet might be needed to observe changes in cognition & other end points. 

3. This trial did not include participants with high cholesterol, or those on statins, which likely increased the difficulty in detecting diet-related effects.

4.  The study size was small

5.  There may be nutrition & diet factors that when combined together would show even more profound effects on the Alzheimer's/Dementia biomarkers.  Consider lower fat, different ratios of macronutrients, and a diet combined with foods that are high in certain nutrients known for brain health.

6.  The study's counter viewpoint:   “We are getting closer to the day where we might give someone an anti-Alzhimer's diet prescription, but we are not there yet,” says P. Murali Doraiswamy, MD, professor of psychiatry and head of the division of biological psychiatry at the Duke University Medical Center in Durham, NC--who wasn't involved in the study.

“There are many unknowns here, such as how a person’s genetic makeup influences how their diet affects the brain, so it’s entirely possible that a low-fat diet may just help people with a certain genetic makeup," Doraiswamy says.

 Me:  Sure, additional studies are needed--ones that are larger and last longer, so we can tease out a number of variables. And this is just one small study--that's certainly not "prescription-ready".  It's a step in a hopeful direction.

But, let's face it--Alzheimer's takes years to develop, and often we don't know we're at risk until it's too late.

If you're already in or past middle age--why delay in making such simple risk-free diet modifications that have a long history in also preventing type-2 diabetes, strokes, and heart disease?   What could be the possible harm?   

And wouldn't it be fascinating to see a study like this one done with a nutrient-dense plant-based diet, that's high in leafy greens, with at least 6 servings of vegetables, high in berries & anthocyanins, high in omega-3s, less than 15% fat, very low levels of saturated fats, no-added oils, and plenty of exercise?    Guess I'll just have to run that experiment on myself!

Any other takers out there? 

Anything you would add to an Alzheimer's Prevention Diet?

 

 

 

 

 

Posted on June 21, 2011 at 07:23 PM | | Comments (6) | TrackBack (0)

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May 18, 2011

The Healthy Librarian Unplugged. Advice from the Experts: Heart, Brain, & Soul Fixes. And How to Go From "Crazy Busy" to a Zen-Like "One Who is Not Busy"

 

 

Unplugged

 

 

Protecting Your Heart (& Brain): The One Lecture You Must Watch

 

 

If you received this post via email, click here to get to the web version, with all the links.

When I heard Dr. Steven Nissen's lecture  two months ago I was stunned.  I couldn't stop talking about it to anyone who would listen.  

Nissen's eye-opening talk on intravasclar ultrasound, atherosclerosis, and reversing heart disease with high-dose statins didn't spend too much time discussing diet or lifestyle changes.  But it certainly convinced me that I was on the right path--to keep on eating a plant-based no-added-oil diet, and to keep on exercising. 

Why?  Because, the inarguable evidence we now have from intravascular ultrasound (IVUS) demonstrates how very low LDL levels can absolutely make a difference in stopping the progression of atherosclerosis--ultimately reversing it.

Nissen, who is the chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic, is one of the top & most respected cardiologists in the country.  When reporters want an opinion about anything related to heart disease, he is the go-to expert. 

What he has to say--and what his power points demonstrate--will convince you that our diet & lifestyle is highly atherogenic--that most of us already have coronary (and/or cerebrovascular) atherosclerosis--in spite of the fact that the majority of us would probably pass a stress test or have normal angiograms.

  • 68% of men & 42% of women who have myocardial infarctions will have less than a 50% stenosis (narrowing) in their coronary arteries--and have no prior symptoms, until an atherosclerotic plaque ruptures from within their arterial wall.  To understand how this can happen, click here.
  • Intravascular ultrasound (IVUS), is a diagnostic technique that's able to measure the arterial plaque within the arterial wall, as well as the opening (lumen) of the artery.  It's used primarily in clinical studies, not for "regular" patients--because it's costly, time-consuming--and involves risk. But, it has completely changed our understanding of how coronary artery disease occurs--and more importantly, how its progression can be stopped, reversed, and prevented.
  • Cardiovascular disease (as well as carotid & renal vascular disease) is NOT a disease caused by the narrowing of the arteries. 

The opening (lumen) of an artery can even look perfectly normal--because this isn't a disease of the lumen--it's a disease of the vessel wall--and angiograms & stress tests cannot pick up what's going on inside the artery's wall.   It's all about that ever-present atherosclerotic plaque embedded inside of our vessel walls.

I'll say it again!  Over half of the time this "Tim-Russert-kind-of-disease" of the vascular wall will not show up on a stress test or be seen on an angiogram--and often it won't cause angina or any other symptoms.  Your cholesterol numbers might even be in the normal or high normal range--not  high enough to warrant more than a low or medium dose of statins. 

With standard diagnostic tools you won't have a clue about what's going on inside of your blood vessels.  And besides, if you don't have angina or serious symptoms--you're never going to have a diagnostic test, anyway.

  • Stents & bypasses won't stop the disease--they'll just get you out of a crisis.  And the typical normal dose of statins can only reduce cardiovascular disease by one-third.
  • How did we get into this mess?  Blame can be placed squarely on our diet and lifestyle.

Sorry that the video of Dr. Nissen's lecture is no longer available. If it were, I'm certain you would come to one of three conclusions:

  • You'll want to take the highest dose of statins your body can tolerate in order to prevent heart disease or stroke--which isn't going to be an easy thing to do, because no physician would likely prescribe such a high-dose of statins just for primary prevention.  And evidence continues to mount of increased side effects the higher the dosage, the longer one is on statins, & the older one's age. 

And after watching the lecture, if you're now wondering about the possible side effects of taking high-dose statins, read "What the Experts Say About the Side Effects of Statins.  What are They?  What Causes Them?  Who is Most at Risk?  How are They Treated"

  • You'll just give up thinking about all this prevention, plaque, heart disease & stroke stuff--eat whatever you want to eat, take what the doc prescribes, and let the chips fall where they may.  You'll probably end up with some level of heart disease, peripheral artery disease, vascular dementia, or renal artery disease, because the cure seems worse than the disease.
  • You'll decide to change your diet from one that's atherogenic & slowly killing you, to one that's plant-based-with-no-added oil, because it will do exactly what the highest doses of statins will do without the side effects.

If by now I've convinced you to listen to what Dr. Steven Nissen has to say, just click here, and plan on spending one hour learning something that many physicians might not be aware of.  And please get back to me--let me know what you think, and what you plan to do about it.   You all know what I've decided to do!

 

Protecting the Brain & the Soul.  Unplugging with a Shot of Nature

 

Son #2 doesn't spend much time surfing the net--and he rarely forwards articles. 

So, when he sent me this one last summer I definitely paid attention: Your Brain on Computers: Outdoors and Out of Reach, Studying the Brain.  It's no coincidence that he also loves to backpack & spend as much free time as he can outdoors.  And since my kid knows that I'm fascinated with brain science--this article was right up both of our alleys!

Here's the story:

Last May five neuroscientists headed into a remote canyon region of southern Utah for a rafting trip and some hands-on evidence-based brain research--on themselves.  They wanted to find out what happens to your brain when you completely unplug from the world.  No phones, no computers, no watches, no devices of any kind.

What the wanted to find out first-hand:  Would you notice any changes to your brain or thought processes if you could immerse yourself in nature, really disconnecting from distractions, technology, constant interruptions, and your work, of course.  

  • Would your focus and attention improve & sharpen without the usual distractions? 
  • Would thoughts deepen, if noise & interruptions could disappear? 
  • Is nature & silence restorative? 
  • Or would you just feel even more anxious if you're cut off from your work, your techno gadgets--and your everyday world?

Starting out, two of the group were believers in the value of escaping into nature--unplugging--and resting the brain.  The other three were skeptics--joined at the hip to their digital devices--and doubtful that the trip would affect them personally or scientifically.

 

"It was a primitive trip with a sophisticated goal:  to understand how heavy use of digital devices and other technology changes how we think and behave, and how a retreat into nature might reverse those effects.

It is a trip into the heart of silence--increasingly rare now that people can get online even in far-flung vacation spots.

By extension, some scientists believe heavy multi-tasking fatigues the brain, draining it of the ability to focus.

As they head down the tight curves the San Juan has carved from ancient sandstone, the travelers will, not surprisingly, unwind, sleep better and lose the nagging feeling to check for a phone in the pocket.

[Dr.] David Strayer, the trip's organizer, a psychology professor at the University of Utah, says that studying what happens when we step away from our devices and rest our brains--in particular, how attention, memory, and learning are affected--is important science.

"Attention is the holy grail,"  says Strayer.

"Everything that you're conscious of, everything you let in, everything you remember and you forget, depends on it."

[Just the expectation of email or receiving new information seems to be taking up our working memory.] 

Working memory is a precious resource in the brain.  The scientists hypothesize that a fraction of brain power is tied up in anticipating email and other new information...

"To the extent you have less working memory, you have less space for storing and integrating ideas and therefore, less to do the reasoning you need to do,"  says [Dr.] Arthur Kramer of the University of Illinois.

"There's a real mental freedom in knowing no one or nothing can interrupt you," says [Dr.] Todd Braver of Washington University. 

When he gets back to St. Louis, Braver plans to focus more on understanding what happens to the brain as it rests.  He wants to use imaging technology to see whether the effect of nature on the brain can be measured and whether there are the other ways to reproduce it, say through meditation.

--Your Brain on Computers: Outdoors and Out of Reach, Studying the Brain, by Matt Richtel, New York Times, August 15, 2010--

 

On Wednesday I'm starting out on my own journey that will disconnect me from my computer and cellphone.  

Neither will get plugged back in until almost mid-June.

It's not exactly a backpacking trip or a silent meditation retreat--but I'll be visiting far-flung places.  The first leg starts with a 20 hour road trip to celebrate & attend son #2's graduation--and then my husband & I will embark on multi-leg journey that's a pre-celebration of our 40th anniversary.  

As soon as we return home, three of our favorite houseguests will have already arrived at our house--our #1 grandson, son #1, and daughter-in-law #1.  Oops--I better thoroughly clean the house & get the bedrooms ready before I leave.

So...I've made the executive decision to leave my computer, my phone, and my blog behind for 3+ weeks and enjoy every moment of this wonderful month with my full attention--minus any distraction.

 

Learning to Let Go of "Crazy Busy"

 

I'm great at making myself crazy when I think I have too much to do. 

You know what I mean.  All that planning in your head that goes into preparing for a long trip.  I'm not a "just show up & fly by the seat-of-my-pants kind of gal".   I wish I was.

I'm the worst combo: a procrastinator who is also an "over-preparer"--who doesn't want to miss out on anything.  Ugh!  Turning easy into complicated is not a good thing--but I'm so good at it!  I think too much--and then try to do it all at the last minute.

  • Researching the destinations--planning what I'm going to see & how to get there.
  • Buying the luggage (the old ones are too heavy), the comfortable walking shoes, the bathing suit (the old one is now too big), figuring out what to pack for every possible circumstance, the foreign currency, and all those little details necessary for travel
  • Planning a celebration-graduation-Friday-night dinner for son #2--Thanks to Eli, this one's going to be easy and amazing!
  • Fitting in all the pre-trip chores into my all-ready jammed-packed schedule
  • While also planning summer visits to North Carolina, Chautauqua, Boston, a family trip to Kentucky, and a July wedding shower.   It's going to be a very busy summer!  OK, I admit it--these all turned out to be easy-to-plan-events and I had plenty of help from others.  It was just the "thinking about them"--and the procrastinating that made them seem so much harder than they were--and drove me crazy.

So it was perfect timing as I tried to fit in one last "before I leave" blog post that thoughts of Norman Fischer serendipitously flew into my head.   Really. 

I reread (and you can, too!) my October 25, 2008 Norman Fischer post about how to calm down when you think your too darn busy.  And honestly, it worked.

 

First Posted:   October 25, 2008 

Serendipitous Saturday--Finding Norman Fischer's Simple Yet Astounding Ways to Calm Down



SerendipitybyOlafGunderson  
Photo: Olaf Gunderson


The Definition of Serendipity: A Seeming Gift for Finding Something Good Accidentally



This morning, through a circuitous route I accidentally found my way to a blog that linked to Norman Fischer, the very wise Jewish Zen master from whom I learned to meditate over 3 years ago.

Norman is the person who gave me: The Best Advice You Can Ever Give Your Grown-up Kids.  It was the subject of one of my earliest posts. You can read that post here.  And he was the one who taught me a Meditation for Dummies technique I blogged about here.

So here's the serendipity part.  I always have things I want to write about--too many.  The problem is, it takes a lot of time to put thoughts to paper (or rather--to computer) and frankly, I've got lots of other stuff to do today.  Like plant flower bulbs, put away my laundry, call my aunt, go for a walk, bake cookies for the new neighbors and hang-out with my husband. I've been mulling over writing posts on multi-tasking; strategies from positive psychology to get through tough economic times; yoga as medicine; and lessons from cultures with lots of centenarians & so on.

So, to continue.  I get to the Norman Fischer link.  It takes me to his newsletter where I learned that Norman not only has a new book out: Sailing Home, but he wrote an article in the September 2008 issue of O Magazine (as in Oprah), called  "Simple Yet Astounding Ways to Calm Down".

As with everything related to Norman, the article is wise, kind, thoughtful, and easy to read.

Forget about reading anything I have to say about multi-tasking, getting through tough times, yoga & longevity.  Read Norman's article!  It's all right there.

And by the way, even though Norman advises against giving advice to grown-up kids, in this case I disagree.  So, Son #1, Son #2, Daughter-in-law #1, if you are reading this, I know you guys are crazy busy.  I hope you have a chance to read Norman!  It will serve you well.

Simple Yet Astounding Ways to Calm Down


Norman Fischer
appearing in O Magazine, September 2008

How to relax
Illustration: Jillian Tamaki

 

"If you're so crazed that you have to pencil in time for a deep breath, here's how to become more relaxed—and efficient—in less than a minute. All together now: Ahhhhh…

You keep a to-do list, but you can't get through it by the end of the day, and you're frustrated because you feel like you haven't been able to get enough done. You find that things take longer than you thought they would. And when people ask how you are, "Fine" has been replaced by "Too busy."

Welcome to the "too busy" club.

In this technology-driven world, we can do more, so we do—and we love it. We feel effective and powerful as we check items off our lists and use our cell phones, BlackBerrys, and computers, sometimes all at once. We're multitasking, doing as much as we can in the least amount of time. We're active, creative, and engaged! In demand! Being too busy makes us feel as though we're making an impact.

On the other hand, feeling too busy drives us crazy. Falling ever further behind as the to-do list relentlessly grows (each item generating many more items almost as fast as we can think of them) is nerve-racking and stressful. We begin to feel like prisoners of the list, prisoners of our lives and our desires, prisoners of time. There just aren't enough hours in the day. It's as if we're doing battle with time—and losing.

But the point is not how many things we have done or will do in a given amount of time; the point is how we do what we do. If we're rushed and frantic, we're too busy. If we move through our tasks with equanimity, patient and composed, we're not.

In the Zen Buddhist tradition that I've been practicing for many years, there's a story that illustrates this point: A monk is sweeping the temple grounds. Another monk comes by and says, "Too busy!" The first monk replies, "You should know there is one who is not too busy."

Our sweeping monk may have been moving quickly, and so he looked "too busy" to his brother monk. But inside—in his mind—he wasn't busy. In the midst of his vigorous activity, he was in touch with "the one who is not busy."

Most of us judge how busy we are by how much we have to do. When there are too many things to do, we think we're busy, and when there isn't much to do, it feels like we're not busy at all. But in fact, we can feel busy when there isn't that much to do, and we can feel relaxed even when there's a lot going on. The states of "busy" and "not busy" aren't defined by how many things there are to do. Contrary to popular opinion, there is no such thing as multitasking; the brain can tend to only one thing at a time. Being too busy or not being busy is an interpretation of our activity. Busy-ness is a state of mind, not a fact. No matter how much or how little we're doing, we're always just doing what we're doing, simply living this one moment of our lives.

That moment may seem long or short. Time is an internal, not external, reality. Have you noticed that half an hour in the dentist's chair lasts longer than half an hour at a fun dinner party with friends? And five minutes waiting on hold on the phone passes more slowly than five minutes watching a movie. Time is how we live it, not what's measured by the clock (after all, the watch was invented fairly recently, in the 16th century). To be sure, our world operates on clock time, which is convenient and necessary; how else would we make it to that dentist's appointment or dinner party? But the clock is supposed to be working for us, not the other way around. If we feel too busy, we've mistaken a feeling for an objective reality and are held captive to that reality. It needn't be that way.

Okay, you say, good theory: We think we're busy, but we're not—we're just doing one thing after another. But the habit of being convinced we're too busy is hard to shake. What can we do about this persistent mania of feeling task- and time-driven?

Understanding something differently is only a beginning. To change the way we live, we have to practice what we've come to understand until it becomes a natural part of us, a habit of thought, feeling, and body. There are many simple techniques that can help us with this. Take three conscious breaths (try it now, as you're reading). This will change your mind. Whatever you're feeling will become less compulsive, less driven. There's a measure of detachment and equanimity even after the first breath. You become more present to your surroundings, to the basic awareness of being alive. Try it the next time you're feeling overwhelmed; it doesn't take much time, and it will help you remember "the one who is not busy," the part of you that's always right there, even when it looks or feels like you're too busy.

Walking meditation—intentionally bringing awareness to your body as you move—can lift you out of a busy-ness-induced, semiconscious funk. If you can become conscious of the way you're moving and the sensation of each movement, you'll feel refreshed instead of rushed. I know what you're thinking: "I'm too busy to go for a walk." But this is something you can do on your way to and from the bathroom. (And if you're really feeling busy, you're probably overdue for a trip there anyway.)

Sometimes just a phrase can help: "Not busy." Remembering our two monks, you can say this softly to yourself when you feel overwhelmed. I do this when I feel crazed; with the repetition of the words, I immediately recognize that it is my feelings and my thoughts that make me feel pressured, not the tasks I have to do. They will get done—or not, and the world and I will survive. Even if I do have a crucial deadline, I'll have a much better chance of making it if I feel "not busy" and can proceed with a calm mind. Feeling frantic doesn't make me more efficient. Quite the contrary, it makes mistakes and glitches more likely.

It goes without saying that if you've bitten off more than you can chew in a day, or in a lifetime, you'd better step back and change your circumstances, if at all possible. Let go of a few activities: Peace of mind is more important, and healthier, than those few extra accomplishments. But if you can't or don't want to change your circumstances, you need to find the most serene and beautiful way to live the life you have.
In the end, if you persistently and unpleasantly feel too busy, remember this: It's not a fact; it's a choice. There is one who is not busy. That one is you."

 

 

Don't Forget!  I'll Be Back Sometime in June!

 

PS:  Don't miss John Tierney's wonderful new article about Dr. Martin Seligman, the founder of positive psychology, in the May 16, 2011 issue of the New York Times,  "Findings: A New Gauge to See What’s Beyond Happiness".  

"[T]he five crucial elements of well-being, each pursued for its own sake: positive emotion, engagement (the feeling of being lost in a task), relationships, meaning and accomplishment.

“Well-being cannot exist just in your own head,” Martin Seligman writes.

“Well-being is a combination of feeling good as well as actually having meaning, good relationships and accomplishment.”'

 

 


 

 

 

 

 

Posted on May 18, 2011 at 05:47 AM | | Comments (16) | TrackBack (0)

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April 11, 2010

A Nitric Oxide Vascular Booster Shot. Remembering My Dad and Father-in-law with a Sardine Swiss Chard Gratin

Sardinesandchard

1.  Nitric oxide is absolutely essential to vascular health--a finding that won the Nobel Prize for Medicine in 1998.

2.  It relaxes blood vessels, selectively boosting blood flow to the organs that need it.  It prevents white blood cells and platelets from becoming sticky, and starting the buildup of vascular plaque.  It lowers blood pressure.

3.  But with every meal of processed oil, dairy or meat we eat, within minutes there is damage & injury to the "life jackets" of our vascular health--which is the single layer of endothelial cells that line all of our blood vessels.

4.  The essential building block for nitric oxide production is an amino acid that is found in rich supply in plant foods.

5. And what can you eat to insure that your endothelial cells will have the raw materials to produce this healing nitric oxide?  Beans & leafy greens.  Load up on kale, collards, Swiss chard, bok choy, & beans and you will be well on your way to healing the linings of your blood vessels.

6. Dr. Esselstyn's patients who adopted a strictly plant-based diet brought about rapid restoration of their endothelial cells' capacity to manufacture nitric oxide--and restore circulation.

-Dr. Caldwell B. Esselstyn, Jr., M.D., Prevent and Reverse Heart Disease-

If you received this post via email, click here for the web version.

Lately, I've been craving Swiss chard.  It's in my shopping cart every time I go to the grocery store--and believe me--I go to the grocery store a lot.

Provencal Greens soup--made with just Swiss chard, dandelion greens, leeks, and vegetable broth.  Can't get enough of it.  Click here for the recipe

So when I saw Martha Rose Shulman's recipe for a Sardine and Chard Gratin in the New York Times on March 29, 2010 I knew I was going to give it a try.  

Now that was a pretty crazy thing for me to do--because number one:  I've never let a sardine pass my lips, ever!  Sardines were my dad's all-time favorite food--but as a kid, their fishy smell and the whole slimy look of canned sardines sent me running out of the kitchen. And number two:  I rarely eat fish these days.

And for years I wouldn't give Swiss chard the time of day, either!  My father-in-law LOVED Swiss chard, and grew it in his summer garden before he retired to Florida.  He was always trying to get me try his chard.  Never even took a single bite.

Now it's always in my fridge, and I blend it into Green smoothies, saute it with garlic, and use it anyway I can think of.  Love it.  If only my father-in-law could see me now.

As soon as I read that Martha Rose Shulman's gorgeous gratin would take 3 pounds of Swiss chard to make--I was bound and determined to give it a try--in spite of those sardines.

My dad and my father-in-law both died from massive strokes--long before we knew a thing about nitric oxide, Swiss chard, or omega 3s.   If only they had known what we know now.

I made my chard gratin when Passover ended--and I could top it with bread crumbs. 

Two days after we enjoyed the Swiss chard gratin I came across this article published last January in the Journal of the American Geriatric Society, with a most appropriate title:  "Impaired Endothelial Nitric Oxide Bioavailability: A Common Link Between Aging, Hypertension, and Atherogenesis?"   So does this mean that you're only as young as your nitric oxide supply holds out?

"Chronological age should no longer be viewed as an irreversible cardiovascular risk factor.  The concept of "vascular age" may be a more useful construct in determining vascular risk.

Accelerated vascular aging and the "age related" vascular disease processes of hypertension and atherosclerosis are associated with impaired endothelial nitric oxide bioavailability at relatively early stages. 

Pharmacotherapeutic intervention aimed at improving endothelial nitric oxide bioavailability has the potential to alter these related disease process."

And who says you need a drug to improve endothelial nitric oxide bioavailability?  A plant-based-diet with plenty of Swiss chard, kale, collards, bok choy, legumes, and beans does a fine job--without the side-effects!  Just ask Dr. Caldwell Esselstyn, Jr. if you don't believe me.

As for the Gratin--it was everything Martha Rose Shulman had promised: 

"This is unbelievably easy to make and so delicious I can hardly believe it's made with sardines from a can. The recipe is a simplified version of a traditional Provencal dish made with fresh sardines and spinach  You can easily throw this dish together on a weeknight."

For the vegans who are reading this--please forgive me for the sardine slip-up.  That's what happens when you're "veganish".  I still do occasionally eat fish--about once every-other-month.  Blame it on my 8 day Passover fast from beans, grains, legumes, and rice.  I needed some protein.

But honestly, I loved those sardines!  I truly am my father's daughter.  And eating them made me think of him and put a big smile on my face!  Sis--have you ever tasted sardines?

And I know I will also lose points for including a recipe that requires a bit of olive oil to give it a true  Provencal taste.  And I'm sure it could be left out.

There's no denying that cold-water fish contain heart healthy omega-3s that have been shown to lower triglycerides, decrease inflammation, as well as reduce the risks of heart disease, stroke, and hypertension.  And even the Environmental Defense Fund puts sardines into the "eco-best category.  Because they are lower on the food chain they have less contaminants.

This dish is dedicated to my Dad who loved sardines, and my father-in-law who loved Swiss chard.  And now I finally understand why.


Dad's Sardine and Swiss Chard Gratin

adapted from a recipe by Martha Rose Shulman

1 3.5-ounce can boneless, skinless sardines packed in olive oil (Martha recommends 2 cans of oil-packed--no need)

1 3.5-ounce can boneless, skinless sardines packed in water

2 1/2 to 3 pounds Swiss chard (about 3 bunches) stemmed--but leave a few inches of stem intact--and wash carefully

1-3 tsp. of olive oil--your choice  (Martha uses 1 TBS.)

1 medium onion finely chopped

2 to 4 garlic cloves, minced

1 TBS. fresh thyme leaves, roughly chopped (or 1 tsp dry)

1/2 cup low-fat unsweetened soy milk

Salt & freshly ground pepper to taste

1/4 cup fresh or dry whole grain bread crumbs.

1. Preheat the oven to 425 degrees. Lightly spray a 2-quart gratin or baking dish. (I used a 10 inch square baking dish) Drain the sardines over a bowl, and separate them into fillets. Set the oil aside.

2. While the chard is still wet from washing, heat a large, heavy skillet over high heat. Working in batches, pile a few handfuls into the pan and stir until the chard begins to wilt. Cover the pan for a minute, then uncover and stir the greens until they have wilted. As each batch collapses, transfer it to a bowl. When you have wilted all of the chard, rinse briefly with cold water, squeeze out excess water and chop medium-fine.

3. Either heat the olive oil (not the oil from the sardines) (or use 1/4 cup of vegetable broth in lieu of oil) in the skillet over medium heat, and add the onion. Cook, stirring, until tender, about five minutes. Add a generous pinch of salt, stir in the garlic and thyme, and cook, stirring, until fragrant, 30 seconds to a minute. Add the chopped, wilted chard and salt and pepper to taste. Stir together for one minute until everything is blended. Add the milk, and stir together for about one minute until you no longer see liquid in the pan. Remove from the heat. Taste, and adjust salt and pepper.

4. Spread half the greens in the bottom of the baking dish. Top with the sardine fillets in one layer. Drizzle a tablespoon or less of the oil from the can over the sardines (or skip this all together), then top with the remaining greens in an even layer. In a small bowl, mix the breadcrumbs well with a small amount of oil--either the reserved sardine oil or fresh olive oil, before sprinkling the crumbs over the chard. 

5.  Place in the oven, and bake 15 minutes until sizzling. Serve hot or warm.

Yield: Serves four to six.

Advance preparation: You can assemble this up to a day ahead of baking. Keep well covered in the refrigerator.

Nutritional count is based on 4 servings per recipe.

Nutrition Facts
The Healthy Librarian's
Dad's Sardine and Swiss Chard Gratine
Serving Size: 1 serving
Amount Per Serving
Calories188
Total Fat9.7g
      Saturated Fat2.5g
      Trans Fat0g
Cholesterol25mg
Sodium462mg
Carbohydrate14.7g
      Dietary Fiber4g
      Sugars3.9g
Protein14.1g
Vitamin A 167%Vitamin C 75%
Calcium    20%Iron 21%

Posted on April 11, 2010 at 06:48 PM | | Comments (6) | TrackBack (0)

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January 02, 2010

It's the Start of the New Year, the Start of the New Decade, and the Start of My Sixties. Some Simple Strategies for Staying Healthy and Happy. At Least I Can Hope!

Bluezones


Author Dan Buettner has scoured the Earth — not for the fabled Fountain of Youth — but for the key to a happy old age. He spent five years visiting areas of the world where people tend to live longer, healthier lives, areas he calls "Blue Zones."

Buettner says he has identified four things people can do that can potentially increase life expectancy:

  • Create an environment that encourages physical activity
  • Set up your kitchen in such a way that you're not overeating
  • Cultivate a sense of purpose 
  • Surround yourself with the right people.

"These are long-term fixes that have been shown over and over to add not only more years of life, but better years of life."

-NPR story, "Can 'Blue Zones' Help Turn Back the Biological Clock?", June 8, 2008-

If you're reading this through via email, click here to get to the more readable web-version.

 

It's the start of the New Year. 

It's the start of a new decade.

It's the day I turn sixty.

Look, I'm not a big-birthday-celebration-kind-of-person.  They come and go and I don't even think about the years.  But turning 60 is different.  It's the last quarter of life, with no guarantees on what that quarter is going to look like.

Judging by my parents--that last quarter of life doesn't look so promising.  Which is exactly why I've been paying attention to exercise and eating right since I turned 30. 

That's when my dad had one of those massive debilitating strokes that left him unable to communicate, unable to read or fully understand speech, and eventually unable to walk or do anything.  He was 69 at the time--just when he was getting ready to kick back a little, work a little less, travel, and just enjoy life.  He spent 16 years living in this kind of post-stroke-limbo-state, spiraling downward.

My mom was 62 at the time, and my dad's stroke changed her life in an instant.  One minute she was planning all the trips they'd finally have a chance to take--and enjoying their new role as grandparents--and in the next she was jockeying the world of wheelchairs and therapists.

With the stress of full-time care-giving, and years of no exercise or attention to diet, by 72 she had developed severe coronary artery blockages, hypertension, kidney stones, and painful spinal fractures.  Then came the mini-strokes that finally added up to vascular dementia in her eighties.

And unfortunately, this scenario is all too common.  "[M]ost elderly Americans – more than two-thirds of current 65-year-olds, according to a detailed 2005 projection by a team of health policy analysts — at some point will need assistance to cope with daily living, either paid help or unpaid, at home or in a facility."

So, sixty seems kind of scary to me.

Which is exactly why I'm ready for a more "Conscious Aging" plan.  We already have all the evidence we need to stay healthy.  It's not about adding more years to our lives.  It's all about adding more life to our years!

Just a sampling of the evidence.

  • The 52 country INTERHEART study was very clear.  There are 9 easy-to-modify risk factors that are associated with 90% of heart disease.  This was a huge study--30,000 people from every inhabited country--and the results were the same for all races, all sexes, all countries.  All 9 of these risk factors are within our control--and would eliminate 90% of heart disease, regardless of one's genetics. 1. Keep lipids (cholesterol & triglycerides) down; 2. Stop smoking; 3. Prevent or control hypertension; 4. Prevent or control diabetes; 5.  Reduce belly fat; 6.  Find ways to control psychological and social stressors; 7. Increase fruit and vegetable consumption; 8.  Moderate alcohol consumption is protective; 9. Get regular physical exercise   Lancet 364:937-952, Sept. 11, 2004.
  • The Nurses' Health Study and Health Professionals Follow-up Study.  "The largest and longest study to date, done as part of the Harvard-based Nurses' Health Study and Health Professionals Follow-up Study, included almost 110,000 men and women whose dietary habits were followed for 14 years.  The higher the average daily intake of fruits and vegetables, the lower the chances of developing cardiovascular disease...[F]or every extra serving of fruits and vegetables that participants added to their diets, their risk of heart disease dropped by 4%." Harvard School of Public Health
  • The China Study.  This is Dr. T. Colin Campbell's mammoth 2006 study on the effects of a plant-based diet on health--citing over 750 studies.  The conclusion: People who ate the most-animal-based foods got the most chronic disease.  People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease.  According to Campbell, "Good nutrition supported by exercise, clean water, and sunshine is greater than the sum of its parts.  It's a biological symphony.  My introduction to Dr. T. Colin Campbell
  • The Longevity Personality.  From the Journal of the American Geriatrics Society, April 2009 comes this conclusion: Those who live the longest are more outgoing, more active, more easy-going, more empathetic, and more agreeable than those who live a normal life span. The Blue Zones calls it, "likeability".

Here's My Strategy for Staying Out-of-Trouble After Sixty

Some of these are long-time habits, and they're easy for me to follow.  Some of these I don't do as regularly as I should.  Some of these are new goals.  But this much I do know:  If I don't have a plan, if I don't do these consciously, and if I don't carve out time to make them happen--they won't.

1.  Stick with 7-9 servings of fruits and vegetables a day.  The Green Smoothies make it easy.  I get 6 servings in a 27 ounce Klean Kanteen that I divide over breakfast and an afternoon snack.  I calculated the nutritional info on my daily 27 ounce serving that includes, 2 1/2 cups kale, 8 mini-carrots, 1/2 cup pomegranate juice, 1/2 apple, 1/2 orange, 1/2 kiwi, and 3/4 cup frozen black raspberries.  Check out the nutrient content for 27 ounces:

Nutrition Facts
The Healthy Librarian's
Green Smoothie-kale,blackberries,carrots,orange,kiwi,pom juice,apple
Serving Size: 1 serving
Amount Per Serving
Calories 342
Total Fat 2.2g
      Saturated Fat 0.2g
      Trans Fat 0g
Cholesterol 0mg
Sodium 140mg
Carbohydrate 82.1g
      Dietary Fiber 13.8g
      Sugars 49.1g
Protein 8.9g
Vitamin A 729% Vitamin C 485%
Calcium    35% Iron 28%

 

Then throw in some veggie-based soup, a salad, a veggie-based dinner entree, some fruit for dessert, and I'm good to go. 

This eating plan is the same as the DASH Diet (Dietary Approaches to Stop Hypertension)--guaranteed to stop hypertension.  The Cache County (Utah) Study on Memory shows it also prevents cognitive decline.   Dr. Amy Lanou and Michael Castleman, authors of Building Bone Vitality claim it will build and strengthen bones--because the 17 nutrients necessary to build strong bones are all found in a diet high in fruits and vegetables.

2.  A balanced exercise plan.  It's not just about cardio--there are 4 areas that need attention: Cardio (spinning-my fave), Weight-training, Flexibility & Balance (yoga-my fave), and Core Strength.  No, you can't just walk and think you're in good shape.  I'm super regular with my cardio, and not as regular with the weight training and yoga.  Click here to see what my workout looks like. As for core strength--that's pretty much non-existent.  And when it comes to weight-training, according to Randy Raugh, the Canyon Ranch physical therapist, and author of the excellent Prime for Life--Functional Fitness for Ageless Living--to get the maximum benefits you need to do it for 3 non-consecutive days a week--2 at the minimum.  Unfortunately, I often weight train only 1 day a week.  If you want to build strong bones and prevent osteoporosis, and maintain your muscle strength as you age--weight-bearing exercise for the lower body, and weight-training for the upper body is a must-do!  Yoga, helps with balance, preventing future falls, and building strength.  As for core strength, I'm upping my game with Dr. Stuart McGill's routine, and my birthday-present to myself is the physical therapist-designed Pelvicore exercise ball.

3.  A plant-based diet with minimal added fat.  I'm nearing the 2 year mark on eating plant-based, so this is the easy part. I've got this down pat. I still use a little olive oil for cooking and in salads, and very occasionally eat some seafood or dairy when eating with friends.  I'm convinced.  If you want to lower your cholesterol, reduce your risk for type-2 diabetes, lower your blood pressure, reduce your risk of heart disease & stroke, and reduce your belly fat--this is the way to go.  Dr. David J. Jenkins of St. Michael's Hospital in Toronto is one of the pre-eminent researchers on the benefits of a plant-based, low-glycemic diet (like beans, nuts, oats,& quinoa) for improving diabetes control, lowering cholesterol, and preventing cardiovascular disease.  Click here for Jenkins research.  And that's not all--keeping your blood sugar stable with low glycemic plant-based foods and exercise will preserve your brain.  Click here.  And as for too much fat--not only is it bad for your belly--it's bad for your brain--so just ditch it Click here.

4. No time urgency.  This is what keeps the Okinawans calm, relaxed, and living longer.  I'm really working on this one--which goes hand-in-hand with flexibility.  Things don't always go as planned--you either go-with-the-flow or get stressed and anxious.  My favorite 2 words, "Oh well."  Life goes better when you stay in the moment, chill, and don't worry about getting there fast.  When our Christmas Day trip to New York City was aborted because of an ice storm, we checked into a hotel at noon, and enjoyed a dinner of cranberry nut mix, Larabars, Cliff Bars, and clementines.  All the restaurants were closed in this Pennsylvanian town.  Oh well.  We had a good time, and made it to New York safe and sound the next day.

5. More Dancing, Singing, Laughing, Playing, Schmoozing, and Mahjing.  What's the point of staying healthy without having fun?  That's the reason we work at staying healthy. Cool fact: There's a little organ deep in the ear, called the sacculus--and it gives us a great sense of pleasure and well-being when it's stimulated.  But, it can only be stimulated through singing!  So, bring on the Singstar Karaoke!  Click here.

6.  The Supplements.  I'm really bad at regularly taking supplements.  I'm good at counting them out, taking them to work, and bringing them back home with me.  Truth is, there are some supplements worth taking because there's no easy way to get enough of them through diet alone.  Here are my favorites:  Omega-3s (I use Omega-Brite), DHA, (an omega-3 for brain health), Magnesium, Citracal, Vitamin D (I'm up to 3000 IUs), Curcumin (also known as turmeric, the yellow color in curry), and Juvenon (the combo of acetyl l-carnitine & alpha lipoic acid) developed by Dr. Bruce Ames.  Click here to read more about what I take, and what some prominent physicians take.  

7.  Eliminate the time-wasters from my day.  Except for watching "The Middle" or "Glee", TV watching always leaves me bored and unsatisfied.  So, why bother wasting the precious time?  The same goes for my mindless internet cruising, checking in more than necessary with email, the NYT, and other favorite sites.  Enough already!

8.  Maximize my peak energy times of the day.  Over a year ago I blogged about getting in sync with our natural energy ebb and flow throughout the day.  It works--and I intend to start planning my day around them, when possible.  For instance, 9-11 is the peak time for brain work-creativity-and analytical work.  On days when I don't work I would usually use this time for exercise & errands.  Poor use of brain time.  Better to exercise between 3-6.  To read more, click here:  Maximize Your Energy-Match Your Tasks to Your daily Energy Levels.

9.  Give a gift a day for 29 days a month.  When 36 year old Cami Walker of LA learned she had multiple sclerosis, her spirits flagged.  She was tired, in pain, and had the prospect of a debilitating disease ahead of her.  When a holistic health educator gave her the prescription of giving 29 gifts a day for a month she thought it sounded it crazy.  Nothing big (and that's the point)--something like making a supportive phone call or saving a piece of yummy cake for her husband.  Of course the prescription didn't cure her,  but it had a startling effect of helping her cope with her illness and gave her a more positive outlook on life.  I love this idea.  It's a planned regular way to just think about kindness.  No big acts, just something little-done everyday.  To read more, click here.

10. Cultivate my garden of friends and family.  Regular phone calls, visits, dinners, outings, and celebrations.  At 60 there's no time to delay any of these.  It's the glue that keeps us together and makes life worth living.

11.  Once You're Through Learning--You're Through.  This is the philosophy of John Wooden, the 97-year-old retired UCLA basketball coach.  No doubt about it, learning and sharing what I learn is my purpose in life.  I'm lucky to have a job that gives me access to learning about health and medicine, and a hobby that gives me a chance to share what I learn.

12.  Start Eating Less.  OK, I'm ready to shed a few pounds, and I know from past experience that writing down exactly what I eat, and how much I've exercised, really works.  I use something called MyFoodDiary.com and it's set up with all my favorite recipes.  Unfortunately, I haven't used it in quite some time.  The new year is a great time to start!  To read more about this tool, click here.

For some good reasons to eat less, read:  CALERIE: The NIH Calorie-Restriction Experiment. Lessons for Health, Slowing Down the Aging Process, Longevity, and Disease Prevention 

 

 

Time to end this list.  I've already maximized my 9-11 brain time and written this post.  It's now time to make my smoothie, do some core exercises, take those supplements, answer birthday phone calls, enjoy a birthday lunch, followed by an evening out with friends who all share the same wedding anniversary--if we can just make it through our foot of snow!

I'd love to hear from anyone who is 60 or over with advice, tips, and wisdom about maximizing life in the sixties, seventies, and more.



 

 

Posted on January 02, 2010 at 08:31 AM | | Comments (11) | TrackBack (0)

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June 29, 2009

The Vital Trial/Study Is Announced. Can 2000 IUs of Vitamin D & 1 gram of Omega 3/Fish Oil Reduce the Risk of Heart Disease, Stroke or Cancer? New Study Starts In 2010

   Vitamindfish Vitamindfish Vitamindfish Vitamindfish


Vitamin D & Omega 3-s (fish oil) are my two favorite supplements. 

I "aim" for 2000 IUs a day of vitamin D, and about 1 gram of omega-3/fish oil--on the days that I get around to taking them.   For my past posts on these supplements click here and here and here.

Researchers have been singing the praises of vitamin D & fish oil for years now--and the evidence keeps piling up.

Now finally, we may (or maybe not) get some answers, when a new randomized controlled study of 20,000 men & women is completed.  Are these truly "miracle supplements" or are we just wasting our money?  This new study is set to begin in January 2010 & run for 5 years.

One big problem:  The study is recruiting women over age 65, and men over age 60!   That seems to be a continuing problem with these studies.  They start out with too old of an age group and they run for too short of a time to really give us good information.  Remember what happened with the Women's Health Initiative?

Dr. Christopher Gardner of Stanford University is usually skeptical of this sort of study.  To be valid, such a trial would have to run for 40 years, because that’s how long it takes to develop a chronic disease, like cancer, heart disease & diabetes.

Dr. Walter Willett, the prominent Harvard nutritionist & epidemiologist notes that it can take many years for nutritional benefits to show up. In the Physician’s Health Study, one of the longest running randomized studies, the cognitive/memory benefits of beta-carotene supplements did not show up after even 12 years.

It took 18 years of taking the supplements for the brain benefits to show up!

According to Dr. Michael Holick, one of the foremost authorities on vitamin D,  infants who are deficient in vitamin D never attain genetically preprogrammed bone density or height.  And the risk of multiple sclerosis increases from a cumulative childhood deficiency of vitamin D.  We all know that heart disease, stroke & cancer take years to develop.  Running a study that last only 5 years, on men and women over age 60 & 65 seems like a case of TOO LITTLE TOO LATE.

Here's the Press Release:

Massive vitamin-D/omega-3 trial for CVD, cancer prevention

June 29, 2009 | Shelly Wood

Boston, MA - A massive, National Institutes of Health-sponsored study looking at whether vitamin-D and/or omega-3 fatty-acid supplementation can reduce the risk of developing heart disease, stroke, or cancer will get under way in January 2010, according to a website for the study. Drs JoAnn Manson and Julie Buring (Harvard Medical School/ Brigham and Women's Hospital, Boston, MA) will head up the Vitamin D and Omega-3 Trial (VITAL).

The study is aiming to enroll 20 000 men and women, one-quarter of whom will be black. According to a Brigham and Women's Hospital press release, the study is intentionally aiming to illuminate a potential racial and ethnic disparity hypothesized to be linked to vitamin D [1]. "African Americans have a higher risk of vitamin-D deficiency as well as a greater frequency of diabetes, hypertension, and certain types of cancer," a press release notes. For VITAL, women need to be over age 65 to enter the study; men need to be over age 60.

Study participants will be randomized to one of four groups: daily vitamin D (2000 IU) and fish oil (1 g); daily vitamin D and fish-oil placebo; daily vitamin-D placebo and fish oil; or daily vitamin-D placebo and fish-oil placebo. The trial will run for five years and is expected to cost US $20 million.

Source
  1. Brigham and Women's Hospital. Largest study of vitamin D and omega-3s set to begin soon at Brigham and Women's Hospital [press release]. June 23, 2009. Available here.
For the link to the Official Vital website click HERE.  Enrollment begins after Labor Day.

Gwen Mergian, who writes a blog called: Healthy Habits: Better Nutrition and Better Health for the Albany Times Union just blogged about my What The Experts Say About The Side Effects of Statins.  What Are They?  What Causes Them? Who Is Most At Risk?  How Are They Treated?  post, written on June 27th.
 
Thanks so much, Gwen!  You can read it here.  Gwen is a nurse who completely changed her diet & exercise habits when she discovered she had dangerously high cholesterol levels and did not want to go the statin/medication route.  She writes an inspiring commentary about her experiences living the "healthy life".  And yes, she lowered her cholesterol to amazing levels through an almost vegan low fat diet, ala Dr. Dean Ornish--and she's reaping the benefits.

Posted on June 29, 2009 at 07:27 PM | | Comments (2) | TrackBack (0)

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November 19, 2008

The Inflammation Connection--Statins, CRP & the JUPITER Study. The Non-Prescription Way to Prevent Heart Attacks & Strokes



Prescriptionmedicine

This is part two of a post on the JUPITER Study & statins--to read part one click here:
 

"My own research has shown that for all the statins, they have this interesting phenomena. What we call two-fer drugs---they both lower cholesterol and they lower the inflammatory process."

 -Dr. Paul Ridker, lead author of the JUPITER STUDY, November 2008-

"From 25 to 30 million healthy, middle-aged American are at far higher risk (of heart disease) than they and their doctors understand them to be, because we're not taking inflammatory factors into account."  

-Dr. Paul Ridker, New York Times November 14, 2002-

"C-Reactive protein (CRP) may be the most predictive for cardiovascular killers such such as heart attack, stroke, and vascular disease.  Studies have shown that people with elevated CRP run two times the risk of dying from cardiovascular-related problems compared with those who have high cholesterol levels. Combine a cholesterol burden with a markedly elevated CRP and your risk of heart attack and stroke increases by a factor of nine."

-Dr. Stephan Sinatra, "Statins: grossly overprescribed for cholesterol and underprescribed for internal inflammation" The Sinatra Health Report, Sept. 2002-


Just to recap:  The JUPITER Study enrolled healthy volunteers, not at risk for heart attack or stroke under current guidelines, and treated them with statins. The 18,000 men & women in the study had low LDLs & weren't hypertensive, but they did have CRP (inflammation) levels over 2.0, which as you can see below put them in the intermediate risk category for cardiovascular disease.  The problem is, most physicians usually do not test for CRP--especially for people with normal cholesterol levels.

Less than 1.0 mg/L = Low Risk for CVD
1.0-2.9 mg/L = Intermediate Risk for CVD
Greater than 3.0 mg/L High Risk for CVD

The results were amazing--the average risk for heart attack and stroke was cut in half.  In fact, the study was halted because of its overwhelming success. The volunteers taking the placebo were given the opportunity to also take the statins.

Dr. Ridker's most important point:  "The inflammation is telling us the likelihood that plaque could rupture.  And that rupture process is what shuts off the oxygen to your heart, or to your brain, and causes that heart attack and stroke.  We now teach Harvard Medical students about atherosclerosis in a very different way than I was taught.  We now teach the students it's a disease of cholesterol and it's a disease of inflammation."

Was the Study Stacked with Overweight People with High Blood Pressure Who Didn't Exercise?

No!  This is straight from Dr. Ridker & why we need to pay attention to this study.
“One of the most remarkable findings here was that we had about 6500 individuals who have an increased level of hs-CRP and no other major risk factors according to our current guidelines-- and that group got approximately a 40% reduction. It says to us that this inflammatory process, which we can’t feel, we can’t tell, we don’t do well, is driving off a lot of this.”
This group had low LDL levels, was of normal weight, non-smoking, & non-hypertensive.

Are the Results Questionable Because a Drug Company Sponsored the Research & Ridker Invented the hs-CRP Test?

No!  As for questions about AstraZeneca’s sponsorship, it was a randomized double-blind, placebo-controlled trial. According to Ridker:

“There is no way the sponsor can deal with it (the study or data). The company never had access to the unblinded data until after the manuscript was written & submitted. It was as tight of control as possible.”

Ridker developed the hs-CRP test precisely because he knew inflammation was key to the development of heart attacks & strokes.

How Do Statins Lower the Heart Attack & Stroke Risks in People Who Already Have Normal Cholesterol?

As Ridker says, statins are 2-fer drugs.  It's a happy coincidence that they not only lower cholesterol, but they also lower inflammation.  Evelyn Tribole, MS RD points out that:

While statins are well known for lowering cholesterol, they also blunt the effects of excessive omega-6 fats, which are at the root of inflammation. For example, statins prevent the release of arachidonic acid from the LDL-cholesterol (Kim, Am J Clin Nutr 2008). Arachidonic acid is the potent omega-6 fat, which increases blood clots, arrhythmias and stiffens arteries.

Let Me Get This Straight.  Why Would I Want to Take a Drug That Has Side Effects If I Just Want To Lower My Inflammation? Is There a Non-Drug Way to Lower Inflammation Without Risks?

Exactly right!  Dr. Ridker and most cardiologists will be the first ones to advise going to the gym, changing your diet & lifestyle before getting on a lifetime course of statins.

There are many ways to naturally lower your inflammation and I'll list them for you at the end of this post.  And guess what?  The best part is that the natural ways to lower inflammation aren't just 2-fer drugs like the statins, they're  Five-fer non-drugs! 

Not only will they cut your risk of heart disease & stroke, but they just may cut your risk for cancer, Alzheimer's, joint pain, depression, hypertension, and perhaps help you live longer, as well!

An anti-inflammatory diet, exercise, adequate Vitamin D, stress control & solid sleep will lower your CRP levels--cut your inflammation--make you healthy--and put you in a good mood.  A Happy Healthy Long Life!!  Honestly, I know it sounds like snake oil & junk science, but it's backed by research study after research study. 

Why take a 2-fer drug like a statin, when you can potentially prevent 5 diseases/conditions with diet & lifestyle changes?  Unless, you have to take a statin--in which case, you gotta do what works for you.  If I had to take a statin, I absolutely would. It's a powerful drug with a good safety profile that has benefited many. But there is an alternative.

I Thought the Body Needs Cholesterol to Properly Function.  What Happens If My Cholesterol is Normal & I Lower It Too Much?

According to a Phd Candidate in Nutrition at UNC Chapel Hill:

"The target of statins is a cholesterol synthesis enzyme. This biochemical pathway is also crucial for formation of Vitamin D, cellular membranes, bile acids and steroid hormones. It also is very important for nerve signaling.

So as statins target cholesterol synthesis, they are also affecting these secondary processes. It is no surprise that some people are feeling awful, have pain, etc.

I hope both physicians and patients are cognizant of this and are thoughtful in their decision to use this controversial drug."

In a Nutshell, How Can I Lower Inflammation and Reduce My Risk of Heart Disease & Stroke?
  • First, have a hs-CRP test to see what your level of inflammation is. If it's over 1, make these changes, and then follow-up to see if you are able to lower your inflammation with diet & lifestyle modifications.  If not, then you may have to go the statin route.
  • Eliminate bad fats.  Cut out saturated fat--red meat (unless it's grass-fed)--full-fat dairy foods.  Eliminate trans fat--fried foods--commercially prepared baked goods.
  • Eliminate the Omega-6 oils: safflower, sunflower, corn, cottonseed & peanut oils.
  • Use canola, flaxseed or walnut oil in small amounts when you do need to use oil.
  • Increase you omega-3 consumption.  Eat wild salmon or other high omega-3 fish twice a week. Don't eat farm-raised salmon or tilapia, which are high is Omega 6's. Add ground flax seed and a small amount of walnuts.  Supplementing with highly refined pharmaceutical grade fish oil capsules will lower triglycerides and lower inflammation.  Check with www.consumerlab.com for the best brands. OmegaBrite & Minami brands were given the "very highest" ratings by Consumer Labs.
  • The ratio of Omega 6's to 3's should be 2:1, or ideally 1:1.  Currently, for most Americans, the ratio is 17:1 in favor of heart-disease-causing Omega 6's.
 
  • Be sure to ask your doctor for the serum 25-hydroxyvitamin D test to measure your Vitamin D level & based on that decide if you need to get a full 1000 IUs of vitamin D  (my doctor recommends up to 2000 IUs for me, given my test results & Northern gray location)
  • Get enough sleep & treat sleep apnea if you have it.
  • Take a multivitamin.
  • Get 20 grams of fiber for every 1,000 calories you eat per day. That's 30-40 grams of fiber a day, depending on how many calories you eat.
  • Stay hydrated.
  • Eat lots of fruit & vegetables (7-9 a day) high in antioxidants--kale, collards, Swiss chard and spinach are highest in this category.  See Dr. Fuhrman's ANDI scale for fruits & veggies highest in anti-oxidants.  Click here
  • Garlic
  • Foods high in magnesium--400 mg a day is needed.  Consider taking a supplement if you aren't getting adequate amounts in your diet
  • 1/2 regular aspirin (162 mg) or 2 baby aspirins every day if you're a man over 35 or woman over 40 (use with caution because of gastric upset & bleeding risk) Talk to your physician about this one!
  • Floss your teeth daily
  • Take a curcumin capsule (a component of the spice turmeric which has anti-inflammatory properties)
  • Eat only whole grains--but try to keep consumption low.  Eliminate white flour, white rice, sugared soda.
  • Cut back on sugar. Even too many fruits can raise triglycerides in some people. If your triglycerides are high--eat whole fruit (not juice) & limit quantities to 2/day. Increase your vegetable intake.
  • Watch your alcohol consumption. In some people alcohol dramatically raises triglycerides.  You'll only know if you respond to alcohol this way by eliminating it, & then measuring your triglycerides.
  • If you're overweight, losing just 5% - 10% of your weight will lower your triglycerides.  When you lose weight, belly fat is the first to go & that's associated with higher triglycerides & inflammation. Women should try get their waist to less than 31 inches, men under 40 inches. For more incentive to ditch the belly fat, click here.
To read a very enlightening transcript of Dr. Paul Ridker and Dr. Mark Hlatky about the JUPITER Statin study on NPR's Science Friday, November 14, 2008, click here.

If you missed my post on reversing heart disease that explains how you can have a heart attack or a silent stroke even if you think you don't have heart disease or atherosclerosis, click here.

If you missed my post on "Do Statins Make You Stupid? Asks Wall Street Journal & the New York Times", click here.

Helpful books on preventing/treating heart disease through diet & lifestyle changes.

What You Must Know about Statin Drugs & Their Natural Alternatives.  Dr. Jay S. Cohen.

The Spectrum. A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight & Gain Health.
Dr. Dean Ornish.

Prevent and Reverse Heart Disease.  Caldwell B. Esselstyn, Jr.

The Queen of Fats. Why Omega-3s Were Removed from the Western Diet and What We Can Do to Replace Them.  Susan Allport.

















Posted on November 19, 2008 at 07:47 PM | | Comments (0) | TrackBack (0)

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